Provider Demographics
NPI:1891302030
Name:ZAC'S PROMISE ADVANCED THERAPY
Entity Type:Organization
Organization Name:ZAC'S PROMISE ADVANCED THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AVI
Authorized Official - Middle Name:
Authorized Official - Last Name:ORLANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-578-7408
Mailing Address - Street 1:7 CAINS RD
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-1703
Mailing Address - Country:US
Mailing Address - Phone:917-578-7408
Mailing Address - Fax:
Practice Address - Street 1:7 CAINS RD
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-1703
Practice Address - Country:US
Practice Address - Phone:917-578-7408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty