Provider Demographics
NPI:1841076510
Name:ZAMORA, ROSALYN (APN)
Entity type:Individual
Prefix:MRS
First Name:ROSALYN
Middle Name:
Last Name:ZAMORA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 WOBBLY BARN RD
Mailing Address - Street 2:
Mailing Address - City:HENRYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18332-7735
Mailing Address - Country:US
Mailing Address - Phone:646-533-2554
Mailing Address - Fax:
Practice Address - Street 1:2 PARK ST
Practice Address - Street 2:
Practice Address - City:BLAIRSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07825-2515
Practice Address - Country:US
Practice Address - Phone:908-362-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14913100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily