Individual provider Active NPI

George Patrick Zurenda Jr., LCSW-R

  • Clinical Social Worker
  • Ithaca, NY
National Provider Identifier
1629121991
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R043285 Issued in NY
Practice address
213 N Aurora St
Ithaca, NY 14850-4360
Phone
(607) 272-1911
Fax
(607) 272-1911
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R043285 NY Primary

Addresses

Primary practice location

213 N Aurora St
Ithaca, NY 14850-4360

Mailing address

PO Box 660
Ithaca, NY 14851-0660
Phone (607) 227-1911

Other names 1

  • Mr. G. P. Zurenda Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R043285NYMDClinical Social Worker
043285NYMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329868800000",
    "number": "1629121991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148510660",
            "telephone_number": "607-227-1911",
            "fax_number": "607-272-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 N AURORA ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504360",
            "telephone_number": "607-272-1911",
            "fax_number": "607-272-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZURENDA",
        "first_name": "GEORGE",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2012-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R043285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "G.",
            "last_name": "ZURENDA",
            "middle_name": "P.",
            "prefix": "MR.",
            "credential": "LCSW-R",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.