Provider Demographics
NPI:1538328661
Name:ZIEZIULEWICZ, KATHLEEN A (RN, CDE)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:A
Last Name:ZIEZIULEWICZ
Suffix:
Gender:F
Credentials:RN, CDE
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Other - First Name:
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Mailing Address - Street 1:501 NEW KARNER RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-3882
Mailing Address - Country:US
Mailing Address - Phone:518-452-1337
Mailing Address - Fax:518-724-6660
Practice Address - Street 1:501 NEW KARNER RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3882
Practice Address - Country:US
Practice Address - Phone:518-452-1337
Practice Address - Fax:518-724-6660
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY491910163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9061131OtherAETNA
NY1G1521OtherEMPIRE BC
NY000418106001OtherBSNENY
NY129658OtherGHI-HMO
NY300797OtherSENIOR WHOLE HEALTH
NY10135297OtherCDPHP
NY6020316OtherMVP HEALTHCARE