Provider Demographics
NPI:1316534266
Name:IGLESIA, ZAZRIEL V (PHARMD)
Entity Type:Individual
Prefix:
First Name:ZAZRIEL
Middle Name:V
Last Name:IGLESIA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ZAZRIEL
Other - Middle Name:B
Other - Last Name:VILLAMOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:5840 FARRINGTON RD APT 215
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-8215
Mailing Address - Country:US
Mailing Address - Phone:831-261-5287
Mailing Address - Fax:
Practice Address - Street 1:4037 DURHAM CHAPEL HILL BLVD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2516
Practice Address - Country:US
Practice Address - Phone:919-765-0009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-27
Last Update Date:2020-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29262183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist