Healthcare Provider Details

I. General information

NPI: 1841755592
Provider Name (Legal Business Name): MATTHEW JAMES ZIMARDO DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2019
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 LIVELY STREAM WAY BLDG 254
GETTYSBURG PA
17325-6021
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-337-4515
  • Fax:
Mailing address:
  • Phone: 717-851-1405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT027534
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: