Healthcare Provider Details

I. General information

NPI: 1497550248
Provider Name (Legal Business Name): DIANA ZADRIMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DIANA TINAJ LMFT

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1983 CROMPOND RD STE 203
CORTLANDT MANOR NY
10567-4121
US

IV. Provider business mailing address

1 CANDLEWOOD CT
THORNWOOD NY
10594-2130
US

V. Phone/Fax

Practice location:
  • Phone: 914-380-8636
  • Fax: 914-380-8636
Mailing address:
  • Phone: 914-557-9239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number002412
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: