Provider Demographics
NPI:1235849472
Name:ZENAROSA, CARLO JOSE (NP)
Entity Type:Individual
Prefix:
First Name:CARLO JOSE
Middle Name:
Last Name:ZENAROSA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:CJ
Other - Middle Name:
Other - Last Name:ZENAROSA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:663 LOCUST ST APT 4G
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-2634
Mailing Address - Country:US
Mailing Address - Phone:914-619-7346
Mailing Address - Fax:
Practice Address - Street 1:55 PALMER AVE
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-3403
Practice Address - Country:US
Practice Address - Phone:914-787-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF432426363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty