Healthcare Provider Details

I. General information

NPI: 1689536385
Provider Name (Legal Business Name): CAROLYN ZEZIMA LP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 E 14TH ST APT 8A
NEW YORK NY
10009-2835
US

IV. Provider business mailing address

455 E 14TH ST APT 8A
NEW YORK NY
10009-2835
US

V. Phone/Fax

Practice location:
  • Phone: 847-507-1785
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number001271
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: