Provider Demographics
NPI:1891095170
Name:ZIENTEK, MICHELLE M (RN)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:M
Last Name:ZIENTEK
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 1:2600 ELMWOOD AVE
Mailing Address - Street 2:APT 5
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1943
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2600 ELMWOOD AVE
Practice Address - Street 2:APT 5
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1943
Practice Address - Country:US
Practice Address - Phone:716-874-9487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY405265-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse