Provider Demographics
NPI:1881251957
Name:ZALTA, DANIELLE ESTHER
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ESTHER
Last Name:ZALTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1468 E 3RD ST FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5503
Mailing Address - Country:US
Mailing Address - Phone:347-743-0999
Mailing Address - Fax:
Practice Address - Street 1:1468 E 3RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5503
Practice Address - Country:US
Practice Address - Phone:347-743-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY80840Medicaid