MEDICARE: MRS. HEATHER ANITA ZIMMERMAN OD

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	152W00000X	Optometrist	OEG003097	PA
2	152W00000X	Optometrist	TUV008324	NY

General Provider Information

NPI Number	:	1164806782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEATHER ANITA ZIMMERMAN OD

Provider Business Mailing Address
First Line	:	101 NEW MEADOW RUN DR
Second Line	:	PO BOX 10
City	:	FARMINGTON
State	:	PA
Zip	:	15437-1391
Country	:	US
Telephone Number	:	724-749-1513
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 NEW MEADOW RUN DRIVE
Second Line	:	OAK VALLEY MEDICAL AND DENTAL, PC
City	:	FARMINGTON
State	:	PA
Zip	:	15437-0010
Country	:	US
Telephone Number	:	724-749-1513
Fax Number	:

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

Provider Enumeration Date	:	07/14/2015
Last Update Date	:	07/23/2015

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