MEDICARE: DR. PHILIP ZIMRING D.M.D.

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	1223E0200X	Endodontics	0296731	NY

General Provider Information

NPI Number	:	1073512612
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP ZIMRING D.M.D.

Provider Business Mailing Address
First Line	:	141 FRANKLIN PL
Second Line	:	SUITE C
City	:	WOODMERE
State	:	NY
Zip	:	11598-1218
Country	:	US
Telephone Number	:	516-374-3663
Fax Number	:	516-374-4064

Provider Business Practice Location Address
First Line	:	141 FRANKLIN PL
Second Line	:	SUITE C
City	:	WOODMERE
State	:	NY
Zip	:	11598-1218
Country	:	US
Telephone Number	:	516-374-3663
Fax Number	:	516-374-4064

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

Provider Enumeration Date	:	07/16/2005
Last Update Date	:	07/08/2007

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