Provider Demographics
NPI:1912189416
Name:KORNECKI, ZBIGNIEW S (RN)
Entity Type:Individual
Prefix:MR
First Name:ZBIGNIEW
Middle Name:S
Last Name:KORNECKI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7258 BRADFORD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-1303
Mailing Address - Country:US
Mailing Address - Phone:215-332-8051
Mailing Address - Fax:
Practice Address - Street 1:7258 BRADFORD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149-1303
Practice Address - Country:US
Practice Address - Phone:215-332-8051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN289812L163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency