Provider Demographics
NPI:1033733969
Name:ZIELKE, ABIGAIL KAY (OD)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:KAY
Last Name:ZIELKE
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 1:1103 S BEYER RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48601-8400
Mailing Address - Country:US
Mailing Address - Phone:989-907-9402
Mailing Address - Fax:
Practice Address - Street 1:3140 TROY SCHENECTADY RD
Practice Address - Street 2:
Practice Address - City:NISKAYUNA
Practice Address - State:NY
Practice Address - Zip Code:12309-1719
Practice Address - Country:US
Practice Address - Phone:518-782-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-06
Last Update Date:2020-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009127152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist