Provider Demographics
NPI:1013193697
Name:ZAWILINSKI, NICOLOTTE (OD)
Entity Type:Individual
Prefix:DR
First Name:NICOLOTTE
Middle Name:
Last Name:ZAWILINSKI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3061 N SHARON AMITY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-6600
Mailing Address - Country:US
Mailing Address - Phone:704-567-6755
Mailing Address - Fax:
Practice Address - Street 1:3061 N. SHARON AMITY RD.
Practice Address - Street 2:SUITE A
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205
Practice Address - Country:US
Practice Address - Phone:704-567-6755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4643152W00000X
NC2103152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist