Provider Demographics
NPI:1134497365
Name:ZIRULNIK, TANIA JESSICA (CM, LM)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:JESSICA
Last Name:ZIRULNIK
Suffix:
Gender:F
Credentials:CM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 6TH AVE
Mailing Address - Street 2:SUITE 3L
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4971
Mailing Address - Country:US
Mailing Address - Phone:347-460-0695
Mailing Address - Fax:646-741-8561
Practice Address - Street 1:511 6TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4971
Practice Address - Country:US
Practice Address - Phone:347-460-0695
Practice Address - Fax:646-741-8561
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF001451-1176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife