Individual
CAROLYN LEIGH ZAWISLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
333 COTTMAN AVE, PHILADELPHIA, PA 19111-2434
(215) 728-2500
(215) 728-3639
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 728-2500
(215) 728-3639
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA058865
PA
363A00000X
Physician Assistant
PA10171
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
353543701
—
TX
Enumeration date
12/02/2015
Last updated
04/03/2017
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