Provider Demographics
NPI:1548576200
Name:ZATINA EGAN, DAYNA MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DAYNA
Middle Name:MARIE
Last Name:ZATINA EGAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 HOWARD BLVD
Mailing Address - Street 2:
Mailing Address - City:MT ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07856-1315
Mailing Address - Country:US
Mailing Address - Phone:973-601-0100
Mailing Address - Fax:973-440-1656
Practice Address - Street 1:111 HOWARD BLVD
Practice Address - Street 2:
Practice Address - City:MT ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07856-1315
Practice Address - Country:US
Practice Address - Phone:973-601-0100
Practice Address - Fax:973-440-1656
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019673103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWVE061OtherAGENCY MEDICARE #
NY00355940OtherAGENCY MEDICAID PROVIDER
NY1285628552OtherAGENCY NPI #