Healthcare Provider Details

I. General information

NPI: 1982718169
Provider Name (Legal Business Name): SHELDON ZUCKERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 07/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1103 STEWART AVE
GARDEN CITY NY
11530-4886
US

IV. Provider business mailing address

1103 STEWART AVE
GARDEN CITY NY
11530-4886
US

V. Phone/Fax

Practice location:
  • Phone: 516-745-0303
  • Fax: 516-745-0588
Mailing address:
  • Phone: 516-745-0303
  • Fax: 516-745-0588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number112834
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: