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General NPI Number Information
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NPI Number | 1174764104
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Entity Type | Individual
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Provider Name | OMAR JESUS ZURITA LCSW
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Gender | Male
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Dates
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Enumeration Date | 03/21/2009
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 11835 QUEENS BLVD SUITE 400
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City | FOREST HILLS
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State | NY
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Zip | 11375-7200
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Country | US
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Telephone | 917-415-8764
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Fax | 718-425-4251
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Provider Business Mailing Address
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Address Line | 11835 QUEENS BLVD STE 400
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City | FOREST HILLS
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State | NY
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Zip | 11375-7211
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Country | US
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Telephone | 917-415-8764
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Fax | 877-556-0666
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 081530
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License Number State | NY
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