Provider Demographics
NPI:1407134513
Name:ZAMBRANA, PAMELA A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:A
Last Name:ZAMBRANA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MONTCLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1124
Mailing Address - Country:US
Mailing Address - Phone:917-907-4594
Mailing Address - Fax:
Practice Address - Street 1:7409 37TH AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6300
Practice Address - Country:US
Practice Address - Phone:718-672-1705
Practice Address - Fax:718-672-2027
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY083967-11041S0200X
NJ44SC055609001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool