Provider Demographics
NPI:1366142879
Name:BROCKMAN, ZINA L (DOULA)
Entity type:Individual
Prefix:
First Name:ZINA
Middle Name:L
Last Name:BROCKMAN
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11755 122ND PL
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-2723
Mailing Address - Country:US
Mailing Address - Phone:347-327-4279
Mailing Address - Fax:
Practice Address - Street 1:11755 122ND PL
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-2723
Practice Address - Country:US
Practice Address - Phone:347-327-4279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula