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General NPI Number Information
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NPI Number | 1447254909
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Entity Type | Individual
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Provider Name | STEPHEN I. ZIMMERMAN P.T., D.P.T., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 06/11/2005
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Last Update Date | 12/04/2007
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Provider Practice Location Address
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Address Line | 2421 GRAND AVE
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City | BALDWIN
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State | NY
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Zip | 11510-3219
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Country | US
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Telephone | 516-377-7964
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Fax | 516-377-7760
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Provider Business Mailing Address
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Address Line | 2421 GRAND AVE
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City | BALDWIN
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State | NY
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Zip | 11510-3219
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Country | US
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Telephone | 516-377-7964
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Fax | 516-377-7760
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251E1300X
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Taxonomy Name | Clinical Electrophysiology Physical Therapist
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License Number |
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 003994-1
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License Number State | NY
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