Healthcare Provider Details

I. General information

NPI: 1962485490
Provider Name (Legal Business Name): STEVEN B ZIPIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 01/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 WATERMAN AVE
EAST PROVIDENCE RI
02914
US

IV. Provider business mailing address

318 WATERMAN AVE
EAST PROVIDENCE RI
02914
US

V. Phone/Fax

Practice location:
  • Phone: 401-438-5950
  • Fax: 401-435-2561
Mailing address:
  • Phone: 401-438-5950
  • Fax: 401-435-2561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD4717
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number55697
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: