Healthcare Provider Details

I. General information

NPI: 1881663755
Provider Name (Legal Business Name): DANIEL M. ZIRKMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 09/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 IRON BRIDGE RD SUITE 4
FREEHOLD NJ
07728-5306
US

IV. Provider business mailing address

495 IRON BRIDGE RD SUITE 4
FREEHOLD NJ
07728-5306
US

V. Phone/Fax

Practice location:
  • Phone: 732-688-9988
  • Fax: 732-866-9998
Mailing address:
  • Phone: 732-866-9988
  • Fax: 732-866-9998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA59539
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: