Healthcare Provider Details

I. General information

NPI: 1164420535
Provider Name (Legal Business Name): DONALD ZUCKERMAN MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 05/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 CONNECTICUT AVE NW STE 301
WASHINGTON DC
20008-2531
US

IV. Provider business mailing address

6827 4TH ST NW APT 106
WASHINGTON DC
20012-1922
US

V. Phone/Fax

Practice location:
  • Phone: 202-483-2660
  • Fax: 202-882-6868
Mailing address:
  • Phone: 202-483-2660
  • Fax: 202-882-6868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC302973
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: