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General NPI Number Information
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NPI Number | 1922492065
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Entity Type | Organization
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Legal Business Name | RUBEN D ZORRILLA
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Dates
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Enumeration Date | 03/26/2015
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Last Update Date | 03/26/2015
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Provider Practice Location Address
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Address Line | 2311 REGINA AVE # 1
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-2434
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Country | US
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Telephone | 718-954-1702
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Fax |
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Provider Business Mailing Address
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Address Line | 2311 REGINA AVE # 1
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-2434
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | RUBEN D ZORRILLA
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Credential |
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Telephone | 718-954-1702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 094279-1
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License Number State | NY
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