Provider Demographics
NPI:1841278603
Name:ZELENSKI, MARCI RAE (PA C)
Entity type:Individual
Prefix:MRS
First Name:MARCI
Middle Name:RAE
Last Name:ZELENSKI
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 1:119 WILSON RD
Mailing Address - Street 2:
Mailing Address - City:BENTLEYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15314-1027
Mailing Address - Country:US
Mailing Address - Phone:724-239-4700
Mailing Address - Fax:724-483-8900
Practice Address - Street 1:119 WILSON RD
Practice Address - Street 2:
Practice Address - City:BENTLEYVILLE
Practice Address - State:PA
Practice Address - Zip Code:15314-1027
Practice Address - Country:US
Practice Address - Phone:724-239-4700
Practice Address - Fax:724-483-8900
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA003288L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP27525Medicare UPIN
PA146577KCQMedicare PIN
PAZE046433Medicare ID - Type Unspecified