Provider Demographics
NPI:1326267295
Name:STELZEL, WIESLAWA ZOFIA (NP)
Entity Type:Individual
Prefix:MRS
First Name:WIESLAWA
Middle Name:ZOFIA
Last Name:STELZEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 SOUND SHORE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901
Mailing Address - Country:US
Mailing Address - Phone:631-722-5293
Mailing Address - Fax:631-722-5293
Practice Address - Street 1:14 GLOVER DRIVE
Practice Address - Street 2:JJ FOLEY SNF SUFFOLK COUNTY DEPARTMENT OF HEALTH
Practice Address - City:YAPHANK
Practice Address - State:NY
Practice Address - Zip Code:11980
Practice Address - Country:US
Practice Address - Phone:631-852-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3014541363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner