Healthcare Provider Details

I. General information

NPI: 1235540592
Provider Name (Legal Business Name): JASON LEE ZIPLOW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 05/09/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 PLAINSBORO RD
PLAINSBORO NJ
08536-1978
US

IV. Provider business mailing address

137 E 28TH ST APT 8B
NEW YORK NY
10016-8166
US

V. Phone/Fax

Practice location:
  • Phone: 609-512-1717
  • Fax:
Mailing address:
  • Phone: 516-587-3772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberMD470384
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: