Healthcare Provider Details

I. General information

NPI: 1245483551
Provider Name (Legal Business Name): DR. WARREN A ZUCKERMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2008
Last Update Date: 04/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3959 BROADWAY COLUMBIA UNIVERSITY PEDIATRICS
NEW YORK NY
10032-1559
US

IV. Provider business mailing address

3959 BROADWAY COLUMBIA UNIVERSITY PEDIATRICS
NEW YORK NY
10032-1559
US

V. Phone/Fax

Practice location:
  • Phone: 212-342-0610
  • Fax: 212-544-1944
Mailing address:
  • Phone: 212-342-0610
  • Fax: 212-544-1944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number239513
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: