MEDICARE: MR. DAVID N. ZIMMER L.M.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	27 021293	NY

General Provider Information

NPI Number	:	1023259389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID N. ZIMMER L.M.T.

Provider Business Mailing Address
First Line	:	455 E 14TH ST
Second Line	:	APT.8D
City	:	NEW YORK
State	:	NY
Zip	:	10009-2801
Country	:	US
Telephone Number	:	917-847-6754
Fax Number	:

Provider Business Practice Location Address
First Line	:	455 E 14TH ST
Second Line	:	APT.8D
City	:	NEW YORK
State	:	NY
Zip	:	10009-2801
Country	:	US
Telephone Number	:	917-847-6754
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2009
Last Update Date	:	03/17/2009

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