Healthcare Provider Details

I. General information

NPI: 1063996403
Provider Name (Legal Business Name): KRISTELI MARIE ZAPPA MONTERROSO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2018
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 90TH ST
BROOKLYN NY
11209-5713
US

IV. Provider business mailing address

225 90TH ST
BROOKLYN NY
11209-5713
US

V. Phone/Fax

Practice location:
  • Phone: 347-860-4527
  • Fax:
Mailing address:
  • Phone: 347-860-4527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number092727
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: