Provider Demographics
NPI:1124302369
Name:ZINK, MARY ELIZABETH (NY229435-1)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELIZABETH
Last Name:ZINK
Suffix:
Gender:F
Credentials:NY229435-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 MIDDLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:NY
Mailing Address - Zip Code:12188-1516
Mailing Address - Country:US
Mailing Address - Phone:518-237-9465
Mailing Address - Fax:518-237-7083
Practice Address - Street 1:125 MIDDLETOWN RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:NY
Practice Address - Zip Code:12188-1516
Practice Address - Country:US
Practice Address - Phone:518-237-0800
Practice Address - Fax:518-237-7083
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY229435-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse