Basic Information
| Provider Information | |||||||||
| NPI: | 1003018557 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZURAWSKI | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 322 NEW DORP LANE | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186674902 | ||||||||
| FaxNumber: | 7186678107 | ||||||||
| Practice Location | |||||||||
| Address1: | 322 NEW DORP LANE | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186674902 | ||||||||
| FaxNumber: | 7186678107 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | LIC034922 | NY | Y | Dental Providers | Dentist |
No ID Information.