MEDICARE: ANDREW ZIMMERMAN MD

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	207R00000X	Internal Medicine Physician	270998	NY

General Provider Information

NPI Number	:	1871883462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW ZIMMERMAN MD

Provider Business Mailing Address
First Line	:	40 GATEWAY DR
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11021-1829
Country	:	US
Telephone Number	:	516-659-1998
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 GATEWAY DR
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11021-1829
Country	:	US
Telephone Number	:	516-659-1998
Fax Number	:

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

Provider Enumeration Date	:	04/15/2011
Last Update Date	:	09/20/2022

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