Provider Demographics
NPI:1285621433
Name:ZARETZKY, JOEL S (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:S
Last Name:ZARETZKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 WAKELEE AVE
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-1145
Mailing Address - Country:US
Mailing Address - Phone:203-735-5444
Mailing Address - Fax:203-735-1469
Practice Address - Street 1:199 WAKELEE AVE
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:CT
Practice Address - Zip Code:06401-1145
Practice Address - Country:US
Practice Address - Phone:203-735-5444
Practice Address - Fax:203-735-1469
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT19620207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB83392Medicare UPIN