Healthcare Provider Details

I. General information

NPI: 1487122735
Provider Name (Legal Business Name): BRITTANY ZUCCO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 03/03/2022
Certification Date: 03/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4455 PORTER RD
NIAGARA FALLS NY
14305-3309
US

IV. Provider business mailing address

460 EAST LN
LEWISTON NY
14092-1326
US

V. Phone/Fax

Practice location:
  • Phone: 716-286-4138
  • Fax:
Mailing address:
  • Phone: 716-930-6391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number105360
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number092943
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: