Provider Demographics
NPI:1932544749
Name:ZAWIDNIAK, JOHN EMIL (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:EMIL
Last Name:ZAWIDNIAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 N MOUNTAIN RD STE 207
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-4325
Mailing Address - Country:US
Mailing Address - Phone:860-524-2610
Mailing Address - Fax:
Practice Address - Street 1:183 N MOUNTAIN RD STE 207
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-4325
Practice Address - Country:US
Practice Address - Phone:860-524-2610
Practice Address - Fax:860-524-2615
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT57290207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology