Provider Demographics
NPI:1659328839
Name:ZAMBRANO, ROSARIO (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSARIO
Middle Name:
Last Name:ZAMBRANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 RIDGEDALE AVE W
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-1634
Mailing Address - Country:US
Mailing Address - Phone:973-672-1212
Mailing Address - Fax:973-672-2722
Practice Address - Street 1:26 BALDWIN ST
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-1302
Practice Address - Country:US
Practice Address - Phone:973-672-1212
Practice Address - Fax:973-672-2722
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06255600208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0113140Medicaid
NJ6739601Medicaid
NJ6739601Medicaid