Provider Demographics
NPI:1285048736
Name:ZATKOWSKI, ROBERT M JR (LPN)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:M
Last Name:ZATKOWSKI
Suffix:JR
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-5702
Mailing Address - Country:US
Mailing Address - Phone:631-957-5954
Mailing Address - Fax:
Practice Address - Street 1:29 LINDEN ST
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-5702
Practice Address - Country:US
Practice Address - Phone:631-957-5954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301436164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse