Provider Demographics
NPI:1386722858
Name:ZARRAGA & ZARRAGA INTERNAL MEDICINE PA
Entity type:Organization
Organization Name:ZARRAGA & ZARRAGA INTERNAL MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:DE LEON
Authorized Official - Last Name:ZARRAGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-422-9140
Mailing Address - Street 1:219 S WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-1957
Mailing Address - Country:US
Mailing Address - Phone:302-422-9140
Mailing Address - Fax:302-422-6017
Practice Address - Street 1:219 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1957
Practice Address - Country:US
Practice Address - Phone:302-422-9140
Practice Address - Fax:302-422-6017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X, 207RI0200X, 207RP1001X
DECI0004034207R00000X
DECL0004035207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0001037302Medicaid
DE0001037302Medicaid
DECJ3176Medicare PIN