Provider Demographics
NPI:1811925597
Name:ZAVALA, RAMON E (MD)
Entity type:Individual
Prefix:
First Name:RAMON
Middle Name:E
Last Name:ZAVALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 COLFAX RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-3109
Mailing Address - Country:US
Mailing Address - Phone:732-940-2479
Mailing Address - Fax:
Practice Address - Street 1:171 JERSEY ST
Practice Address - Street 2:BLDG 36 (561GA)
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08611-2425
Practice Address - Country:US
Practice Address - Phone:609-989-2355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA067404207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG79178Medicare UPIN