Healthcare Provider Details

I. General information

NPI: 1326053802
Provider Name (Legal Business Name): GREGORY ROBERT ZIMBELMAN PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 07/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 JONES HOLLOW RD STE 7
MARLBOROUGH CT
06447-1448
US

IV. Provider business mailing address

14 JONES HOLLOW RD STE 7
MARLBOROUGH CT
06447-1448
US

V. Phone/Fax

Practice location:
  • Phone: 860-295-8188
  • Fax: 860-295-8976
Mailing address:
  • Phone: 860-295-8188
  • Fax: 860-295-8976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7414
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: