Provider Demographics
NPI:1801138284
Name:PROSKUROVSKY, ZORIC LENNIE (MD)
Entity type:Individual
Prefix:
First Name:ZORIC
Middle Name:LENNIE
Last Name:PROSKUROVSKY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 W BAY AVE
Mailing Address - Street 2:
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005-1289
Mailing Address - Country:US
Mailing Address - Phone:609-994-5688
Mailing Address - Fax:609-607-4025
Practice Address - Street 1:912 W BAY AVE
Practice Address - Street 2:
Practice Address - City:BARNEGAT
Practice Address - State:NJ
Practice Address - Zip Code:08005-1289
Practice Address - Country:US
Practice Address - Phone:609-994-5688
Practice Address - Fax:609-607-4025
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-22
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09789100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine