Healthcare Provider Details

I. General information

NPI: 1366622201
Provider Name (Legal Business Name): ROBERT D ZUCKER, DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2007
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7209 BUCKLEY RD
LIVERPOOL NY
13088-3807
US

IV. Provider business mailing address

PO BOX 340 4350 MIDDLE SETTLEMENT RD SUITE C
NEW HARTFORD NY
13413-0340
US

V. Phone/Fax

Practice location:
  • Phone: 315-452-2800
  • Fax: 315-452-2801
Mailing address:
  • Phone: 315-732-9368
  • Fax: 315-732-9403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN002348-1
License Number StateNY

VIII. Authorized Official

Name: ROBERT D ZUCKER
Title or Position: OWNER & OPERATOR
Credential: MD
Phone: 315-452-2800