Provider Demographics
NPI:1558521641
Name:SEBASTIAN, ANGELIE ZAMORA (RN)
Entity Type:Individual
Prefix:MISS
First Name:ANGELIE
Middle Name:ZAMORA
Last Name:SEBASTIAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10918-1329
Mailing Address - Country:US
Mailing Address - Phone:845-610-3286
Mailing Address - Fax:
Practice Address - Street 1:54 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10918-1329
Practice Address - Country:US
Practice Address - Phone:845-610-3286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY447789163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse