Healthcare Provider Details

I. General information

NPI: 1730636473
Provider Name (Legal Business Name): TESSA ZOMPANIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2016
Last Update Date: 06/26/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 PARK LN PARK LANE LEEDS
BROOKLYN NY
11211-2305
US

IV. Provider business mailing address

91 JACKSON ST
BROOKLYN NY
11211-2305
US

V. Phone/Fax

Practice location:
  • Phone: 917-306-8874
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF402262-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: