Provider Demographics
NPI:1750469979
Name:ZAWADZKI, EUGENIA (PA)
Entity Type:Individual
Prefix:
First Name:EUGENIA
Middle Name:
Last Name:ZAWADZKI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2945 LENA CT
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-1349
Mailing Address - Country:US
Mailing Address - Phone:574-299-6088
Mailing Address - Fax:814-616-8884
Practice Address - Street 1:4402 PEACH ST STE 4
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-1375
Practice Address - Country:US
Practice Address - Phone:814-616-0075
Practice Address - Fax:814-281-5956
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2022-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10000958363A00000X
OH50.005099RX363A00000X
NJ25MP00605600363A00000X
NY024720363A00000X
PAMA052296363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000545194OtherANTHEM, BCBS
IN000000545194OtherANTHEM, BCBS
IN151020RRRMedicare PIN
PAQ63075Medicare UPIN