Healthcare Provider Details

I. General information

NPI: 1174766216
Provider Name (Legal Business Name): FEDERICO ZUNIGA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2009
Last Update Date: 04/02/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 1ST AVE NEW YORK UNIVERSITY MEDICAL CENTER- BELLEVUE HOSPITAL
NEW YORK NY
10016
US

IV. Provider business mailing address

455 MAIN ST APT. 15-G
NEW YORK NY
10044-0192
US

V. Phone/Fax

Practice location:
  • Phone: 212-562-4141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number254858
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number048420
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number254858
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: