Provider Demographics
NPI:1205710522
Name:ZITRONENBAUM, SHIA
Entity type:Individual
Prefix:
First Name:SHIA
Middle Name:
Last Name:ZITRONENBAUM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 15TH AVE APT 6J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-3759
Mailing Address - Country:US
Mailing Address - Phone:929-295-2123
Mailing Address - Fax:
Practice Address - Street 1:5000 15TH AVE APT 6J
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-3759
Practice Address - Country:US
Practice Address - Phone:929-295-2123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-31
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker