Healthcare Provider Details

I. General information

NPI: 1235512070
Provider Name (Legal Business Name): MARINA ZAVORY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2015
Last Update Date: 04/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 LORRAINE AVE
MOUNT VERNON NY
10553-1222
US

IV. Provider business mailing address

21 LINDEN ST #26
NORWALK CT
06851-1548
US

V. Phone/Fax

Practice location:
  • Phone: 914-663-7070
  • Fax: 914-663-7075
Mailing address:
  • Phone: 203-856-4746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: