Healthcare Provider Details

I. General information

NPI: 1821741992
Provider Name (Legal Business Name): JAILEEN ZUNIGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2022
Last Update Date: 01/30/2022
Certification Date: 01/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

463 HAWTHORNE AVE
YONKERS NY
10705-3441
US

IV. Provider business mailing address

463 HAWTHORNE AVE
YONKERS NY
10705-3441
US

V. Phone/Fax

Practice location:
  • Phone: 212-437-3500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number795196
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: