Provider Demographics
NPI:1154609410
Name:GONKATE, ZENNAO VANESSA
Entity type:Individual
Prefix:
First Name:ZENNAO
Middle Name:VANESSA
Last Name:GONKATE
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 1:3924 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-2900
Mailing Address - Country:US
Mailing Address - Phone:718-409-6500
Mailing Address - Fax:718-239-1295
Practice Address - Street 1:3924 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2900
Practice Address - Country:US
Practice Address - Phone:718-409-6500
Practice Address - Fax:718-239-1295
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7266905164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY8843OtherSS#