Provider Demographics
NPI:1679033435
Name:ZOMBEK, STEFANIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:
Last Name:ZOMBEK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6102 KNOXBORO RD
Mailing Address - Street 2:
Mailing Address - City:ORISKANY FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13425-3517
Mailing Address - Country:US
Mailing Address - Phone:315-534-8430
Mailing Address - Fax:
Practice Address - Street 1:1651 ONEIDA ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-4866
Practice Address - Country:US
Practice Address - Phone:315-793-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY726101-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse