Provider Demographics
NPI:1902248339
Name:ZIRINO, JENNA L (MSED, BCBA)
Entity Type:Individual
Prefix:MS
First Name:JENNA
Middle Name:L
Last Name:ZIRINO
Suffix:
Gender:F
Credentials:MSED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2227 E 63RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6303
Mailing Address - Country:US
Mailing Address - Phone:718-241-3927
Mailing Address - Fax:
Practice Address - Street 1:2227 E 63RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6303
Practice Address - Country:US
Practice Address - Phone:718-241-3927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
NY1-15-20768103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist