1831340256 NPI number — MRS. CORTNEY LYNN CONDON ZIELASKO MSW

Table of content: MRS. CORTNEY LYNN CONDON ZIELASKO MSW (NPI 1831340256)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831340256 NPI number — MRS. CORTNEY LYNN CONDON ZIELASKO MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CONDON ZIELASKO
Provider First Name:
CORTNEY
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CONDON
Provider Other First Name:
CORTNEY
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1831340256
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
248 AMHERST RD
Provider Second Line Business Mailing Address:
APT S1
Provider Business Mailing Address City Name:
SUNDERLAND
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01375-9476
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-264-1126
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
340 MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 383
Provider Business Practice Location Address City Name:
WORCESTER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01608-1604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-791-4976
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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