Provider Demographics
NPI:1033723598
Name:ZORRILLA, RUBEN D (LMSW)
Entity Type:Individual
Prefix:
First Name:RUBEN
Middle Name:D
Last Name:ZORRILLA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2335
Mailing Address - Country:US
Mailing Address - Phone:718-954-1702
Mailing Address - Fax:
Practice Address - Street 1:9609 40TH RD
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-2138
Practice Address - Country:US
Practice Address - Phone:929-522-0631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094279104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker