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General NPI Number Information
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NPI Number | 1275194110
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Entity Type | Individual
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Provider Name | PATRICIA LORENA ZEA
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Gender | Female
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Dates
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Enumeration Date | 06/21/2019
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Last Update Date | 06/21/2019
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Provider Practice Location Address
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Address Line | 6830 HOSPITAL DR STE 206
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City | ROSEDALE
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State | MD
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Zip | 21237-4377
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Country | US
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Telephone | 410-238-5390
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Fax |
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Provider Business Mailing Address
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Address Line | 10520 LAKESPRING WAY
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City | COCKEYSVILLE
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State | MD
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Zip | 21030-2817
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Country | US
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Telephone | 443-862-6561
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R07665
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License Number State | MD
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