Provider Demographics
NPI:1285960864
Name:ZUKIN, HEATHER NICOLE (MSS)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:NICOLE
Last Name:ZUKIN
Suffix:
Gender:F
Credentials:MSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CUTHBERT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-2295
Mailing Address - Country:US
Mailing Address - Phone:267-277-3220
Mailing Address - Fax:
Practice Address - Street 1:115 CUTHBERT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-2295
Practice Address - Country:US
Practice Address - Phone:267-277-3220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-02
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical