Provider Demographics
NPI:1336168913
Name:ZAWITOSKI, DENISE L (AUD)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:L
Last Name:ZAWITOSKI
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 631568
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21263-1568
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6535 N CHARLES ST STE 250
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-5829
Practice Address - Country:US
Practice Address - Phone:410-821-5151
Practice Address - Fax:410-823-8642
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00634231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKJ47/53443502OtherCAREFIRST MARYLAND GBMC
MD408851400Medicaid
MDS1290024OtherCAREFIRST REGIONAL GBMC
MDP00253082Medicare PIN
MD676LJ804Medicare PIN