Healthcare Provider Details

I. General information

NPI: 1558626606
Provider Name (Legal Business Name): BERNARD ZITRONENBAUM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: BERNARD ZITRONENBAUM MS SPECIAL ED

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1312 38TH ST
BROOKLYN NY
11218-3612
US

IV. Provider business mailing address

1458 50TH ST APT 4
BROOKLYN NY
11219-3678
US

V. Phone/Fax

Practice location:
  • Phone: 718-686-3700
  • Fax:
Mailing address:
  • Phone: 718-436-1929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number623632121
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number001579
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: