Basic Information
Provider Information
NPI: 1992039861
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZENOSKI
FirstName: CHRISTA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
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Mailing Information
Address1: 535 MAIN ST
Address2:  
City: OLEAN
State: NY
PostalCode: 147601500
CountryCode: US
TelephoneNumber: 7163720141
FaxNumber:  
Practice Location
Address1: 14 CENTER ST
Address2:  
City: CUBA
State: NY
PostalCode: 147271002
CountryCode: US
TelephoneNumber: 5859683210
FaxNumber: 5859683031
Other Information
ProviderEnumerationDate: 09/25/2009
LastUpdateDate: 02/08/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X336081NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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