Healthcare Provider Details

I. General information

NPI: 1043281496
Provider Name (Legal Business Name): ROBERT M ZUCKERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 06/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 LINGLESTOWN RD SUITE 160-A
HARRISBURG PA
17110-9499
US

IV. Provider business mailing address

2151 LINGLESTOWN RD SUITE 160-A
HARRISBURG PA
17110-9499
US

V. Phone/Fax

Practice location:
  • Phone: 717-541-8066
  • Fax: 717-671-9157
Mailing address:
  • Phone: 717-541-8066
  • Fax: 717-671-9157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMDO39714-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: