Healthcare Provider Details

I. General information

NPI: 1093523979
Provider Name (Legal Business Name): CLAUDIA ZAVALA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2024
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 5TH AVE
NEW YORK NY
10011-8002
US

IV. Provider business mailing address

201 MARIN BLVD APT 1017
JERSEY CITY NJ
07302-6498
US

V. Phone/Fax

Practice location:
  • Phone: 646-460-0097
  • Fax:
Mailing address:
  • Phone: 914-240-3533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP133110
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: