Healthcare Provider Details

I. General information

NPI: 1497736227
Provider Name (Legal Business Name): JOHN ZELAZOWSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 PITTSBURGH ST
CHESWICK PA
15024-1448
US

IV. Provider business mailing address

1423 PITTSBURGH ST
CHESWICK PA
15024-1448
US

V. Phone/Fax

Practice location:
  • Phone: 724-274-8383
  • Fax: 724-274-3206
Mailing address:
  • Phone: 724-274-8383
  • Fax: 724-274-3206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG7
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: