Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | F421410 | NY |
NPI | 1063058147 |
---|---|
Provider Name | Zuleika Tavarez |
First Address | Bronx, NY 10452-7921 |
Second Address | New York, NY 10032-1559 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2019 |
Last Update Date | 23/11/2019 |