Provider Demographics
NPI:1700444338
Name:ZULETA, ROSEMARIE C (RN)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:C
Last Name:ZULETA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3945 51ST ST APT 5C
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3120
Mailing Address - Country:US
Mailing Address - Phone:347-892-6077
Mailing Address - Fax:
Practice Address - Street 1:3945 51ST ST APT 5C
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-3120
Practice Address - Country:US
Practice Address - Phone:347-892-6077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY584982-1163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysis