Provider Demographics
NPI:1124055884
Name:ZUK, GEORGE P JR (DPM)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:P
Last Name:ZUK
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 NORTH STREET
Mailing Address - Street 2:P.O. BOX 1872
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06011-1872
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:
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
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000512213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT030000512CT01OtherBC/BS OF CT
CT712811OtherCONNECTICARE
CT7426813003OtherCIGNA
CTOVO800OtherHEALTHNET
CT2701451OtherEVERCARE
CTP778770OtherOXFORD INSURANCE
CT030000512CT01OtherBC/BS OF CT