Provider Demographics
NPI:1114650835
Name:ZIELINSKI, CARLA M (OPHTHALMIC DISPENSER)
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:M
Last Name:ZIELINSKI
Suffix:
Gender:F
Credentials:OPHTHALMIC DISPENSER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 KENTUCKY HOME SQ
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-1823
Mailing Address - Country:US
Mailing Address - Phone:502-628-2900
Mailing Address - Fax:
Practice Address - Street 1:215 KENTUCKY HOME SQ
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-1823
Practice Address - Country:US
Practice Address - Phone:502-628-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-09
Last Update Date:2022-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1306156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician