Provider Demographics
NPI:1477301349
Name:ZUNIGA PEREZ, BENJAMIN FRANCISCO (MD MEDICAL DOCTOR)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:FRANCISCO
Last Name:ZUNIGA PEREZ
Suffix:
Gender:M
Credentials:MD MEDICAL DOCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-1921
Mailing Address - Country:US
Mailing Address - Phone:860-679-2147
Mailing Address - Fax:860-679-4624
Practice Address - Street 1:263 FARMINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-1921
Practice Address - Country:US
Practice Address - Phone:860-679-2562
Practice Address - Fax:860-679-4613
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2025-01-30
Deactivation Date:2025-01-09
Deactivation Code:
Reactivation Date:2025-01-30
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program