Provider Demographics
NPI:1548734841
Name:MOJARES, ZENNA (RN)
Entity Type:Individual
Prefix:
First Name:ZENNA
Middle Name:
Last Name:MOJARES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ZENNA
Other - Middle Name:
Other - Last Name:ZAMORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1657 SEDDON ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-3012
Mailing Address - Country:US
Mailing Address - Phone:917-355-2780
Mailing Address - Fax:
Practice Address - Street 1:3175 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-5700
Practice Address - Country:US
Practice Address - Phone:718-239-8239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-20
Last Update Date:2019-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY720556163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice