Healthcare Provider Details

I. General information

NPI: 1497900807
Provider Name (Legal Business Name): CARMEN MARIANA ZUNIGA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARMEN MARIA ZUNIGA-KARTACHOV MD

II. Dates (important events)

Enumeration Date: 11/26/2008
Last Update Date: 02/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4250 BROADWAY RM 1C
NEW YORK NY
10033-3768
US

IV. Provider business mailing address

4250 BROADWAY RM 1C
NEW YORK NY
10033-3768
US

V. Phone/Fax

Practice location:
  • Phone: 212-740-3900
  • Fax: 212-740-8232
Mailing address:
  • Phone: 212-740-3900
  • Fax: 212-740-8232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number193670
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: