Provider Demographics
NPI:1649056425
Name:INZINNA, GREGORY (PSYD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:
Last Name:INZINNA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 DRAKE AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-1751
Mailing Address - Country:US
Mailing Address - Phone:914-309-7058
Mailing Address - Fax:
Practice Address - Street 1:183 DRAKE AVE APT 1A
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10805-1751
Practice Address - Country:US
Practice Address - Phone:914-309-7058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025958103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical