Provider Demographics
NPI:1952472524
Name:FELINSKI, NICOLE EUGENIA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:EUGENIA
Last Name:FELINSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 STONE CT
Mailing Address - Street 2:
Mailing Address - City:PITTSTON TWP
Mailing Address - State:PA
Mailing Address - Zip Code:18640-9528
Mailing Address - Country:US
Mailing Address - Phone:570-654-4598
Mailing Address - Fax:570-454-2144
Practice Address - Street 1:1500 E 36TH ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18202-9394
Practice Address - Country:US
Practice Address - Phone:570-454-1400
Practice Address - Fax:570-454-2144
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA-003380-L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA065011Medicare ID - Type Unspecified
PAP74613Medicare UPIN