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

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	225100000X	Physical Therapist	003994-1	NY

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
2	46295	OTHER	NY	VYTRA PROVIDER #
3	5C7329	OTHER	NY	HEALTHNET PROVIDER #
4	145529P	OTHER	NY	HIP PROVIDER #
5	AZ00575	OTHER	NY	MDNY PROVIDER #
6	0731899	OTHER	NY	CIGNA PROVIDER #
7	259759	OTHER	NY	UNITED HEALTHCARE PROV. #
8	5120L	OTHER	NY	CIGNA ORTHONET PROVIDER #
9	6698763	OTHER	NY	GHI PROVIDER #
10	QM8451	OTHER	NY	EMPIRE BLUE CROSS BLUE SH

General Provider Information

NPI Number	:	1811048549
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN I. ZIMMERMAN, PH.D., P.T., P.C.

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	:	PRESIDENT
Name	:	DR. STEPHEN I. ZIMMERMAN
Credential	:	P.T., D.P.T., PH.D.
Telephone Number	:	516-377-7964

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	12/04/2007

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