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General NPI Number Information
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NPI Number | 1245558394
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Entity Type | Individual
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Provider Name | ALIZA ZUCKER PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 05/13/2010
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Last Update Date | 12/18/2018
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Provider Practice Location Address
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Address Line | 999 CENTRAL AVE
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City | WOODMERE
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State | NY
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Zip | 11598-1205
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Country | US
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Telephone | 516-209-2709
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Fax |
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Provider Business Mailing Address
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Address Line | 133 COMBS AVE
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City | WOODMERE
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State | NY
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Zip | 11598-1432
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Country | US
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Telephone | 516-209-2709
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Fax |
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 017623-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 017623-1
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License Number State | NY
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