Provider Demographics
NPI:1962471342
Name:CRESCENZI, ZINA I (APRN)
Entity type:Individual
Prefix:MS
First Name:ZINA
Middle Name:I
Last Name:CRESCENZI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:ZINA
Other - Middle Name:I
Other - Last Name:MIRMINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:100 DOUBLE BEACH RD
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-4909
Mailing Address - Country:US
Mailing Address - Phone:203-500-4828
Mailing Address - Fax:203-315-7673
Practice Address - Street 1:100 DOUBLE BEACH RD
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-4909
Practice Address - Country:US
Practice Address - Phone:203-315-7540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001740363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTS61704Medicare UPIN
CT500000556Medicare ID - Type Unspecified