MEDICARE: BARRY LEWIS ZIMMERMAN D.O.

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	2084N0400X	Neurology Physician	25MB04607300	NJ

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	:	1467433912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARRY LEWIS ZIMMERMAN D.O.

Provider Business Mailing Address
First Line	:	40 BEY LEA RD
Second Line	:	BLDG C-103
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-2900
Country	:	US
Telephone Number	:	732-367-8280
Fax Number	:	732-367-1529

Provider Business Practice Location Address
First Line	:	40 BEY LEA RD
Second Line	:	BLDG C SUITE 103
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-2900
Country	:	US
Telephone Number	:	732-367-8280
Fax Number	:	732-367-1529

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

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	06/03/2008

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