Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | N-003845 | NY |
Y | 222Z00000X | Podiatrist | N-003845 | NY |
N | 111NR0200X | Radiology | N-003845 | NY |
N | 213ER0200X | Radiology | N-003845 | NY |
N | 2081S0010X | Sports Medicine | N-003845 | NY |
N | 213ES0000X | Sports Medicine | N-003845 | NY |
N | 213ES0131X | Foot Surgery | N-003845 | NY |
NPI | 1326057514 |
---|---|
Provider Name | Dr. Stanley John Zawada |
First Address | Whitestone, NY 11357-1752 |
Second Address | Whitestone, NY 11357-1752 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 21/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00858168 | (05) | NY |
T32164 | (02) | NY |