Provider Demographics
NPI:1710950209
Name:ZAWESKI, JOSEPH E (PAC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:E
Last Name:ZAWESKI
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 1:1C CHESTNUT HILL PLZ
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2701
Mailing Address - Country:US
Mailing Address - Phone:302-266-0930
Mailing Address - Fax:302-731-4130
Practice Address - Street 1:1C CHESTNUT HILL PLZ
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2701
Practice Address - Country:US
Practice Address - Phone:302-266-0930
Practice Address - Fax:302-731-4130
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC50000287363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000024147Medicaid
P24610Medicare UPIN
DE1000024147Medicaid