Provider Demographics
NPI:1447458872
Name:GEORGE P. ZUK, JR., D.P.M.
Entity type:Organization
Organization Name:GEORGE P. ZUK, JR., D.P.M.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:ZUK
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:860-585-0585
Mailing Address - Street 1:6 NORTH ST
Mailing Address - Street 2:P.O. BOX 1872
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-4148
Mailing Address - Country:US
Mailing Address - Phone:860-585-0585
Mailing Address - Fax:860-585-0602
Practice Address - Street 1:6 NORTH ST
Practice Address - Street 2:FLOOR 1
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4148
Practice Address - Country:US
Practice Address - Phone:860-585-0585
Practice Address - Fax:860-585-0602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4912820001Medicare NSC