Healthcare Provider Details

I. General information

NPI: 1093233058
Provider Name (Legal Business Name): ESTELLE ZAGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1955 MCDONALD AVE
BROOKLYN NY
11223-1805
US

IV. Provider business mailing address

3841 BEDFORD AVE
BROOKLYN NY
11229-2411
US

V. Phone/Fax

Practice location:
  • Phone: 718-787-1600
  • Fax:
Mailing address:
  • Phone: 646-549-7472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number100061
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: