Provider Demographics
NPI:1588255350
Name:INFANTOLINO, ZACHARY (PHD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:
Last Name:INFANTOLINO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 BARRETT DRIVE #104
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580
Mailing Address - Country:US
Mailing Address - Phone:908-912-4291
Mailing Address - Fax:
Practice Address - Street 1:70 LINDEN OAKS FL 3
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2804
Practice Address - Country:US
Practice Address - Phone:908-912-4291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2023-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS2521103T00000X
NY023070103T00000X
NJ35SI00600300103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist