Provider Demographics
NPI:1356304851
Name:ZUNIC, MARYJO (PHARMD, BCPS, PHC)
Entity Type:Individual
Prefix:DR
First Name:MARYJO
Middle Name:
Last Name:ZUNIC
Suffix:
Gender:F
Credentials:PHARMD, BCPS, PHC
Other - Prefix:
Other - First Name:MARYJO
Other - Middle Name:
Other - Last Name:BOOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7248 LA JARA CT NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109
Mailing Address - Country:US
Mailing Address - Phone:505-948-1747
Mailing Address - Fax:
Practice Address - Street 1:801 VASSAR DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2725
Practice Address - Country:US
Practice Address - Phone:505-248-7741
Practice Address - Fax:505-248-7642
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPC000001451835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist