Provider Demographics
NPI:1710736061
Name:ZIELINSKI, MIRANDA MARY (PA-C)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:MARY
Last Name:ZIELINSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 CANAL ST APT A
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-6209
Mailing Address - Country:US
Mailing Address - Phone:774-402-4307
Mailing Address - Fax:
Practice Address - Street 1:268 POST RD STE 103
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-6601
Practice Address - Country:US
Practice Address - Phone:401-604-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant