Provider Demographics
NPI:1982136016
Name:ZAPOLSKY, IVAN JOSEPH (MD, MS)
Entity Type:Individual
Prefix:
First Name:IVAN
Middle Name:JOSEPH
Last Name:ZAPOLSKY
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 TECHNOLOGY DR STE 12
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3469
Mailing Address - Country:US
Mailing Address - Phone:631-444-4233
Mailing Address - Fax:631-444-4217
Practice Address - Street 1:14 TECHNOLOGY DR STE 12
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3469
Practice Address - Country:US
Practice Address - Phone:631-444-4233
Practice Address - Fax:631-444-4217
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-29
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316752207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty