Provider Demographics
NPI:1134482003
Name:ZUNIGA, CONSUELO A
Entity Type:Individual
Prefix:
First Name:CONSUELO
Middle Name:A
Last Name:ZUNIGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15512 79TH ST APT 3F
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-2309
Mailing Address - Country:US
Mailing Address - Phone:347-561-3449
Mailing Address - Fax:718-504-4415
Practice Address - Street 1:15512 79TH ST APT 3F
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-2309
Practice Address - Country:US
Practice Address - Phone:347-561-3449
Practice Address - Fax:718-504-4415
Is Sole Proprietor?:No
Enumeration Date:2012-06-16
Last Update Date:2012-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator