Basic Information
| Provider Information | |||||||||
| NPI: | 1851458210 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZARZUELA | ||||||||
| FirstName: | ARMINIA | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 79 | ||||||||
| Address2: | |||||||||
| City: | BAYONNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070020079 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2013391700 | ||||||||
| FaxNumber: | 2013396972 | ||||||||
| Practice Location | |||||||||
| Address1: | 495 N 13TH STREET | ||||||||
| Address2: | COLUMBUS HOSPITAL | ||||||||
| City: | NEWARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9732681400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080N0001X | 25MA049124 | NJ | Y | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2526000 | 05 | NJ | MEDICAID |