Provider Demographics
NPI:1033503941
Name:ZURITA, PAMELA L (RN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:L
Last Name:ZURITA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 VAN NOSTRAND AVE
Mailing Address - Street 2:FRONT APARTMENT
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11024-1822
Mailing Address - Country:US
Mailing Address - Phone:516-633-3893
Mailing Address - Fax:
Practice Address - Street 1:34 VAN NOSTRAND AVE
Practice Address - Street 2:FRONT APARTMENT
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11024-1822
Practice Address - Country:US
Practice Address - Phone:516-633-3893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-28
Last Update Date:2015-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY687551163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse