Provider Demographics
NPI:1215305545
Name:ZIELINSKI, MATEUSZ (ATC)
Entity type:Individual
Prefix:
First Name:MATEUSZ
Middle Name:
Last Name:ZIELINSKI
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 RICHARD CT
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-2305
Mailing Address - Country:US
Mailing Address - Phone:845-290-0396
Mailing Address - Fax:
Practice Address - Street 1:233 RICHARD CT
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-2305
Practice Address - Country:US
Practice Address - Phone:845-290-0396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0030122255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer