Provider Demographics
NPI:1366418543
Name:ZALAZNICK, STEVEN (OD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:ZALAZNICK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-5150
Mailing Address - Country:US
Mailing Address - Phone:973-777-4343
Mailing Address - Fax:973-777-0536
Practice Address - Street 1:177 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-5150
Practice Address - Country:US
Practice Address - Phone:973-777-4343
Practice Address - Fax:973-777-0536
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4071152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0074292Medicaid
NJT49081Medicare UPIN
NJ0074292Medicaid