Provider Demographics
NPI:1609451368
Name:ZARA, VIRGILIO ESGUERRA (RN)
Entity Type:Individual
Prefix:
First Name:VIRGILIO
Middle Name:ESGUERRA
Last Name:ZARA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 WILLIAMS AVE
Mailing Address - Street 2:
Mailing Address - City:HASBROUCK HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604-2120
Mailing Address - Country:US
Mailing Address - Phone:206-330-9950
Mailing Address - Fax:
Practice Address - Street 1:2440 HAMBURG TPKE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-6226
Practice Address - Country:US
Practice Address - Phone:973-839-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR20443400163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse