Provider Demographics
NPI:1780922948
Name:ZINK, MARA LILLIAN (NP)
Entity type:Individual
Prefix:MRS
First Name:MARA
Middle Name:LILLIAN
Last Name:ZINK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARA
Other - Middle Name:
Other - Last Name:BERTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:120 EDIE RD
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-5426
Mailing Address - Country:US
Mailing Address - Phone:914-413-3395
Mailing Address - Fax:212-305-6861
Practice Address - Street 1:161 FORT WASHINGTON AVE FL 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3729
Practice Address - Country:US
Practice Address - Phone:646-317-6626
Practice Address - Fax:212-305-6891
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY615535163WE0003X, 163W00000X
NY430705363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163W00000XNursing Service ProvidersRegistered Nurse