Provider Demographics
NPI:1093819112
Name:ZEGARRA, JAN PIERRE (MD)
Entity Type:Individual
Prefix:MR
First Name:JAN
Middle Name:PIERRE
Last Name:ZEGARRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 270-080
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00928-2780
Mailing Address - Country:US
Mailing Address - Phone:787-763-5670
Mailing Address - Fax:787-753-3584
Practice Address - Street 1:EDIFICIO BUCARE
Practice Address - Street 2:URB BUCARE, CALLE TURQUESA 2050
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-758-5034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR47632086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
1700109OtherHUMANA HEALTH
25716OtherTS
25716OtherTS
E30422Medicare UPIN
25716Medicare ID - Type Unspecified