Healthcare Provider Details

I. General information

NPI: 1265310387
Provider Name (Legal Business Name): ONEIDA MARITH ZAVALA ENAMORADO BSN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 NOSTRAND AVE APT 2B
BROOKLYN NY
11226-4919
US

IV. Provider business mailing address

1513 NOSTRAND AVE APT 2B
BROOKLYN NY
11226-4919
US

V. Phone/Fax

Practice location:
  • Phone: 757-289-6696
  • Fax:
Mailing address:
  • Phone: 757-289-6696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN01427
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: