Healthcare Provider Details
I. General information
NPI: 1952594749
Provider Name (Legal Business Name): PAUL ZUCKER PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/24/2007
Last Update Date: 11/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10 UNION SQ E 5 N
NEW YORK NY
10003-3314
US
IV. Provider business mailing address
60 E 8TH ST 18 B
NEW YORK NY
10003-6514
US
V. Phone/Fax
- Phone: 212-844-8772
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 017525 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: