Provider Demographics
NPI:1780975326
Name:ZOCCA, JENNIFER AMANDA (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:AMANDA
Last Name:ZOCCA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:90 MAIDEN LN
Mailing Address - Street 2:FL 3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4831
Mailing Address - Country:US
Mailing Address - Phone:646-290-9560
Mailing Address - Fax:212-532-4362
Practice Address - Street 1:90 MAIDEN LN
Practice Address - Street 2:FL 3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4831
Practice Address - Country:US
Practice Address - Phone:646-290-9560
Practice Address - Fax:212-532-4362
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-01
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
NY278201207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program