Provider Demographics
NPI:1215674940
Name:ZENTMAN, DAVID BRIAN (LMSW)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:BRIAN
Last Name:ZENTMAN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 GOLDEN RD
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-3221
Mailing Address - Country:US
Mailing Address - Phone:845-270-2254
Mailing Address - Fax:
Practice Address - Street 1:24 GOLDEN RD
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-3221
Practice Address - Country:US
Practice Address - Phone:845-270-2254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-14
Last Update Date:2022-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11332701104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker