Provider Demographics
NPI:1760139349
Name:ZAPATA-MOORE, XIOMARA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:XIOMARA
Middle Name:
Last Name:ZAPATA-MOORE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:XIOMARA
Other - Middle Name:
Other - Last Name:ZAPATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1952 1ST AVE APT 11O
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6451
Mailing Address - Country:US
Mailing Address - Phone:917-428-4053
Mailing Address - Fax:
Practice Address - Street 1:200 GATEWAY PARK DR BLDG B
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-3760
Practice Address - Country:US
Practice Address - Phone:315-391-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115641-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker