Provider Demographics
NPI:1952299810
Name:ZEGARRA MEZA, VERONICA SOFIA
Entity type:Individual
Prefix:MISS
First Name:VERONICA
Middle Name:SOFIA
Last Name:ZEGARRA MEZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8641 56TH AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4861
Mailing Address - Country:US
Mailing Address - Phone:332-290-5344
Mailing Address - Fax:
Practice Address - Street 1:8641 56TH AVE APT 4
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4861
Practice Address - Country:US
Practice Address - Phone:332-290-5344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator