Provider Demographics
NPI:1265729065
Name:RONSAYRO, ESTRELLA ATANACIO (MD)
Entity type:Individual
Prefix:DR
First Name:ESTRELLA
Middle Name:ATANACIO
Last Name:RONSAYRO
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 1:64 TWIN PONDS DR
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2708
Mailing Address - Country:US
Mailing Address - Phone:856-589-8095
Mailing Address - Fax:
Practice Address - Street 1:330 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1121
Practice Address - Country:US
Practice Address - Phone:856-225-1975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04935600207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine