Healthcare Provider Details

I. General information

NPI: 1194632067
Provider Name (Legal Business Name): ANDREANA ZAZZARINO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2408 32ND ST STE 1002D
ASTORIA NY
11102-1197
US

IV. Provider business mailing address

15760 23RD AVE
WHITESTONE NY
11357-3913
US

V. Phone/Fax

Practice location:
  • Phone: 817-723-8917
  • Fax:
Mailing address:
  • Phone: 917-584-8264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number056397
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: