Provider Demographics
NPI:1053185017
Name:INDELICATO, ZAIRA
Entity type:Individual
Prefix:
First Name:ZAIRA
Middle Name:
Last Name:INDELICATO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 JOLINE AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10307-2019
Mailing Address - Country:US
Mailing Address - Phone:917-741-6030
Mailing Address - Fax:
Practice Address - Street 1:72 JOLINE AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10307-2019
Practice Address - Country:US
Practice Address - Phone:917-741-6030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst