Provider Demographics
NPI:1326586025
Name:MUNGO, CINZIA
Entity Type:Individual
Prefix:
First Name:CINZIA
Middle Name:
Last Name:MUNGO
Suffix:
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 1:2940 EAST 196TH STREET
Mailing Address - Street 2:1G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461
Mailing Address - Country:US
Mailing Address - Phone:508-667-9114
Mailing Address - Fax:
Practice Address - Street 1:2940 E 196TH ST
Practice Address - Street 2:1G
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3814
Practice Address - Country:US
Practice Address - Phone:508-667-9114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker