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NPI Code Detail

MEDICARE: MR. STEPHEN I. ZIMMERMAN P.T., D.P.T., PH.D.

MEDICARE:  MR. STEPHEN I. ZIMMERMAN  P.T., D.P.T., PH.D.
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
12251E1300XClinical Electrophysiology Physical TherapistNY
2225100000XPhysical Therapist003994-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1145529POTHERNYHIP PROVIDER #
246295OTHERNYVYTRA
36698763OTHERNYGHI PROVIDER #
4QM8451OTHERNYEMPIRE BC/BS PROV. #
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
60731899OTHERNYCIGNA PROVIDER #
751201OTHERNYCIGNA/ORTHONET PROV. #
8259759OTHERNYUNITED HEALTHCARE PROV. #
9AZ00575OTHERNYMDNY PROVIDER #

General Provider Information

NPI Number : 1447254909
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEPHEN I. ZIMMERMAN P.T., D.P.T., PH.D.
Provider Business Mailing Address
First Line : 2421 GRAND AVE
Second Line :
City : BALDWIN
State : NY
Zip : 11510-3219
Country : US
Telephone Number : 516-377-7964
Fax Number : 516-377-7760
Provider Business Practice Location Address
First Line : 2421 GRAND AVE
Second Line :
City : BALDWIN
State : NY
Zip : 11510-3219
Country : US
Telephone Number : 516-377-7964
Fax Number : 516-377-7760
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2005
Last Update Date : 12/04/2007

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Directions to “ MR. STEPHEN I. ZIMMERMAN P.T., D.P.T., PH.D.” Practice Location

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