Provider Demographics
NPI:1518497395
Name:ZELINSKY, COLLIN F (PAC)
Entity Type:Individual
Prefix:
First Name:COLLIN
Middle Name:F
Last Name:ZELINSKY
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1599
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04402-1599
Mailing Address - Country:US
Mailing Address - Phone:207-404-8200
Mailing Address - Fax:
Practice Address - Street 1:775 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WINTERPORT
Practice Address - State:ME
Practice Address - Zip Code:04496-3414
Practice Address - Country:US
Practice Address - Phone:207-223-0965
Practice Address - Fax:207-223-0975
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA1943363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500729405Medicaid