Healthcare Provider Details

I. General information

NPI: 1063469518
Provider Name (Legal Business Name): DEBORAH ANNE ZINCK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 02/14/2022
Certification Date: 02/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1672 S COUNTY TRL STE 201
EAST GREENWICH RI
02818-5099
US

IV. Provider business mailing address

258 WOODRIDGE DR
SAUNDERSTOWN RI
02874-1942
US

V. Phone/Fax

Practice location:
  • Phone: 401-886-7881
  • Fax:
Mailing address:
  • Phone: 401-294-0220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD 09211
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: