Provider Demographics
NPI:1497868665
Name:ZELASKI, DELPHINE (PAC)
Entity type:Individual
Prefix:
First Name:DELPHINE
Middle Name:
Last Name:ZELASKI
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 N. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ROBERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27871
Mailing Address - Country:US
Mailing Address - Phone:252-795-5555
Mailing Address - Fax:252-795-5566
Practice Address - Street 1:504 N. MAIN STREET
Practice Address - Street 2:
Practice Address - City:ROBERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:27871
Practice Address - Country:US
Practice Address - Phone:252-795-5555
Practice Address - Fax:252-795-5566
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10087363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC58033OtherBLUE CROSS BLUE SHIELD
970020487OtherRAILROAD MEDICARE
NC8958033Medicaid
R40504Medicare UPIN
NC2750073BMedicare PIN