Healthcare Provider Details

I. General information

NPI: 1225480684
Provider Name (Legal Business Name): CARLY HACHEY ZINGONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2016
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 WESTCHESTER AVE
WHITE PLAINS NY
10604-2901
US

IV. Provider business mailing address

2700 WESTCHESTER AVE FL 2
PURCHASE NY
10577-2547
US

V. Phone/Fax

Practice location:
  • Phone: 914-681-3100
  • Fax: 914-682-6588
Mailing address:
  • Phone: 914-607-5730
  • Fax: 914-457-1195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number7007
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number341529
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: