Healthcare Provider Details
I. General information
NPI: 1770667966
Provider Name (Legal Business Name): RICHARD SCOTT ZIPPERMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/24/2006
Last Update Date: 05/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18-15 COLLEGE POINT BLVD
COLLEGE POINT NY
11356
US
IV. Provider business mailing address
18-15 COLLEGE POINT BLVD
COLLEGE POINT NY
11356
US
V. Phone/Fax
- Phone: 718-539-7776
- Fax: 718-539-7558
- Phone: 718-539-7776
- Fax: 718-539-7558
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 3868 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: