Healthcare Provider Details

I. General information

NPI: 1730407271
Provider Name (Legal Business Name): ANTHONY ZUCCARO LCSW-R
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2010
Last Update Date: 05/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 OLD ORANGEBURG ROAD ROCKLAND PSYCHIATRIC CENTER
ORANGEBURG NY
10962
US

IV. Provider business mailing address

18 CHURCH STREET NYACK CONSULTATION CENTER
NYACK NY
10960
US

V. Phone/Fax

Practice location:
  • Phone: 845-359-1000
  • Fax:
Mailing address:
  • Phone: 845-358-1677
  • Fax: 845-358-3640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number023833
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: