Provider Demographics
NPI:1851742423
Name:CO, MITA ZAHRA ESTRADA (MD)
Entity Type:Individual
Prefix:
First Name:MITA ZAHRA
Middle Name:ESTRADA
Last Name:CO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:825 TOWN CENTER DR STE 152
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1793
Mailing Address - Country:US
Mailing Address - Phone:215-741-3510
Mailing Address - Fax:773-665-3401
Practice Address - Street 1:825 TOWN CENTER DR STE 152
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1793
Practice Address - Country:US
Practice Address - Phone:215-741-3510
Practice Address - Fax:773-665-3401
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036155939207R00000X
CAA160905207R00000X
ND19269207RN0300X
PAMD475173207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine