Healthcare Provider Details

I. General information

NPI: 1760806590
Provider Name (Legal Business Name): HATIDZA ZUNIC M.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2014
Last Update Date: 02/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 TENNENT RD STE 103
MANALAPAN NJ
07726-3149
US

IV. Provider business mailing address

710 TENNENT RD STE 103
MANALAPAN NJ
07726-3149
US

V. Phone/Fax

Practice location:
  • Phone: 732-536-9906
  • Fax: 732-536-9907
Mailing address:
  • Phone: 732-536-9906
  • Fax: 732-536-9907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA06934700
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. HATIDZA ZUNIC
Title or Position: PRESIDENT
Credential: MD
Phone: 732-536-9906