Provider Demographics
NPI:1871819805
Name:ALTORK, ZERESH AMBER (M ED, CD, CCE)
Entity Type:Individual
Prefix:MS
First Name:ZERESH
Middle Name:AMBER
Last Name:ALTORK
Suffix:
Gender:F
Credentials:M ED, CD, CCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2663 SE 28TH CIR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-8969
Mailing Address - Country:US
Mailing Address - Phone:561-808-3142
Mailing Address - Fax:
Practice Address - Street 1:2112 S CONGRESS AVE STE 104
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33406-7670
Practice Address - Country:US
Practice Address - Phone:561-653-6292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-15
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health