Provider Demographics
NPI:1114992948
Name:ZIERENBERG, CHARLES EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:EDWARD
Last Name:ZIERENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 29134
Mailing Address - Street 2:DEPARTAMENTO DE ORTOPEDIA RCM
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0134
Mailing Address - Country:US
Mailing Address - Phone:787-764-6095
Mailing Address - Fax:787-620-0714
Practice Address - Street 1:ORTOPEDIA RCM PISO 9 SUITE 595
Practice Address - Street 2:CENTRO MEDICO DE PR, BO. MONACILLOS
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00935
Practice Address - Country:US
Practice Address - Phone:787-764-5095
Practice Address - Fax:787-620-0714
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR8561207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR29033Medicare ID - Type Unspecified
PRC77666Medicare UPIN