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General NPI Number Information
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NPI Number | 1063058147
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Entity Type | Individual
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Provider Name | ZULEIKA TAVAREZ NP
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Gender | Female
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Dates
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Enumeration Date | 11/23/2019
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 3959 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10032-1559
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Country | US
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Telephone | 212-305-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 155 E 168TH ST APT 3B
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City | BRONX
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State | NY
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Zip | 10452-7921
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Country | US
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Telephone | 347-849-3303
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 405549
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | F421410
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License Number State | NY
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