Healthcare Provider Details

I. General information

NPI: 1033191036
Provider Name (Legal Business Name): ALAN TODD ZIMBARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 PELHAM PKWY N
BRONX NY
10469-5411
US

IV. Provider business mailing address

1101 PELHAM PKWY N
BRONX NY
10469-5411
US

V. Phone/Fax

Practice location:
  • Phone: 718-519-8152
  • Fax: 718-515-2616
Mailing address:
  • Phone: 718-519-8152
  • Fax: 718-515-2616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number125776
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: