Healthcare Provider Details

I. General information

NPI: 1689588154
Provider Name (Legal Business Name): ATARA ZOLDAN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CEDAR LN STE 304
TEANECK NJ
07666-4417
US

IV. Provider business mailing address

215 AYCRIGG AVE APT 3B
PASSAIC NJ
07055-4731
US

V. Phone/Fax

Practice location:
  • Phone: 201-252-7689
  • Fax:
Mailing address:
  • Phone: 973-723-9875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: