MEDICARE: DR. MARYJANE ZIMAROWSKI

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	74509	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417954595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARYJANE ZIMAROWSKI

Provider Business Mailing Address
First Line	:	640 MEMORIAL DR
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02139-4853
Country	:	US
Telephone Number	:	781-255-0555
Fax Number	:	781-255-0594

Provider Business Practice Location Address
First Line	:	330 BROOKLINE AVE
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02215-5400
Country	:	US
Telephone Number	:	617-667-4344
Fax Number	:

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	10/18/2025

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