Healthcare Provider Details

I. General information

NPI: 1528044856
Provider Name (Legal Business Name): DEBORAH MICHELLE ZOLOT PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 CLARKSON AVE I BLDG 2ND FL
BROOKLYN NY
11203
US

IV. Provider business mailing address

50 LEXINGTON AVE
NEW YORK NY
10010
US

V. Phone/Fax

Practice location:
  • Phone: 718-245-2520
  • Fax:
Mailing address:
  • Phone: 212-684-3237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number016406
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: