MEDICARE: DONALD ZUCKERMAN MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LC302973	DC

General Provider Information

NPI Number	:	1164420535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD ZUCKERMAN MSW

Provider Business Mailing Address
First Line	:	6827 4TH ST NW
Second Line	:	APT 106
City	:	WASHINGTON
State	:	DC
Zip	:	20012-1922
Country	:	US
Telephone Number	:	202-483-2660
Fax Number	:	202-882-6868

Provider Business Practice Location Address
First Line	:	3000 CONNECTICUT AVE NW
Second Line	:	STE 301
City	:	WASHINGTON
State	:	DC
Zip	:	20008-2531
Country	:	US
Telephone Number	:	202-483-2660
Fax Number	:	202-882-6868

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	05/05/2017

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