Healthcare Provider Details
I. General information
NPI: 1902248339
Provider Name (Legal Business Name): JENNA L ZIRINO MSED, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/26/2013
Last Update Date: 05/20/2022
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2227 E 63RD ST
BROOKLYN NY
11234-6303
US
IV. Provider business mailing address
2227 E 63RD ST
BROOKLYN NY
11234-6303
US
V. Phone/Fax
- Phone: 718-241-3927
- Fax:
- Phone: 718-241-3927
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-15-20768 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: