Provider Demographics
NPI:1043056914
Name:ZINCKE, CARLENE C
Entity type:Individual
Prefix:
First Name:CARLENE
Middle Name:C
Last Name:ZINCKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 E 72ND ST # 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5421
Mailing Address - Country:US
Mailing Address - Phone:561-414-7330
Mailing Address - Fax:631-850-6859
Practice Address - Street 1:1127 E 72ND ST # 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5421
Practice Address - Country:US
Practice Address - Phone:561-414-7330
Practice Address - Fax:631-850-6859
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY366547163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management