Provider Demographics
NPI:1043769698
Name:ZULAUF, CHAYA CHAYA I
Entity Type:Individual
Prefix:MISS
First Name:CHAYA
Middle Name:CHAYA
Last Name:ZULAUF
Suffix:I
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 1:636 EASTERN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-3320
Mailing Address - Country:US
Mailing Address - Phone:347-244-9113
Mailing Address - Fax:
Practice Address - Street 1:636 EASTERN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-3320
Practice Address - Country:US
Practice Address - Phone:347-244-9113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health