Provider Demographics
NPI:1467590281
Name:GOLONKA, ZBIGNIEW (PHD)
Entity Type:Individual
Prefix:MR
First Name:ZBIGNIEW
Middle Name:
Last Name:GOLONKA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8764 STONEHOUSE DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-1931
Mailing Address - Country:US
Mailing Address - Phone:203-598-1796
Mailing Address - Fax:
Practice Address - Street 1:135 N GEORGE ST
Practice Address - Street 2:CGA PROFESSIONAL CENTER
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17401-1132
Practice Address - Country:US
Practice Address - Phone:877-777-5393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008551L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist