Provider Demographics
NPI:1497900971
Name:ZALDIVAR, MARJEL (DO)
Entity Type:Individual
Prefix:DR
First Name:MARJEL
Middle Name:
Last Name:ZALDIVAR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MAX DR
Mailing Address - Street 2:APT 1A
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-3043
Mailing Address - Country:US
Mailing Address - Phone:718-309-3864
Mailing Address - Fax:
Practice Address - Street 1:203 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-3648
Practice Address - Country:US
Practice Address - Phone:973-992-5588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2011-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08935600208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics