Healthcare Provider Details

I. General information

NPI: 1952486128
Provider Name (Legal Business Name): MARA ZOTTA PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 N FRANKLIN TPKE STE 324
RAMSEY NJ
07446-1601
US

IV. Provider business mailing address

128 VILLAGE CIR W
PARAMUS NJ
07652-5322
US

V. Phone/Fax

Practice location:
  • Phone: 551-206-9368
  • Fax:
Mailing address:
  • Phone: 551-206-9368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number016846-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35SI00530200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: