Healthcare Provider Details

I. General information

NPI: 1750759411
Provider Name (Legal Business Name): DAVID ANTHONY ZIMCOSKY PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2015
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 EUCLID AVE # A-40
CLEVELAND OH
44103-3736
US

IV. Provider business mailing address

4500 EUCLID AVE # A-40
CLEVELAND OH
44103-3736
US

V. Phone/Fax

Practice location:
  • Phone: 216-476-7312
  • Fax:
Mailing address:
  • Phone: 216-218-1723
  • Fax: 216-445-3385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number50.004526RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: