Provider Demographics
NPI:1043479561
Name:JOHN L. ZBOINSKI DPM, PC
Entity type:Organization
Organization Name:JOHN L. ZBOINSKI DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZBOINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:845-876-8637
Mailing Address - Street 1:91 MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1122
Mailing Address - Country:US
Mailing Address - Phone:845-876-8637
Mailing Address - Fax:845-876-0218
Practice Address - Street 1:91 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1122
Practice Address - Country:US
Practice Address - Phone:845-876-8637
Practice Address - Fax:845-876-0218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN-005181213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
480030230OtherRAILROAD MEDICARE
NYPH8991OtherBLUE CROSS
480030230OtherRAILROAD MEDICARE
U62409Medicare UPIN
NYPH8991OtherBLUE CROSS