Provider Demographics
NPI:1992722425
Name:ESPINO-OSTMAN, ZENAIDA L (MD)
Entity type:Individual
Prefix:
First Name:ZENAIDA
Middle Name:L
Last Name:ESPINO-OSTMAN
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 1:394 SAMPLE BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ENOLA
Mailing Address - State:PA
Mailing Address - Zip Code:17025-1021
Mailing Address - Country:US
Mailing Address - Phone:717-790-9745
Mailing Address - Fax:
Practice Address - Street 1:601 PARK ST
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-0601
Practice Address - Country:US
Practice Address - Phone:570-253-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD31166L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009932140014Medicaid
PAP00952236OtherRR MEDICARE
PAE80591Medicare UPIN
PA0009932140014Medicaid
PA218320YETGMedicare PIN
PA244366Medicare PIN