MEDICARE: DR. GARY B ZIMBERG MD

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	2084P0802X	Addiction Psychiatry Physician	MD039356L	PA
2	2084P0805X	Geriatric Psychiatry Physician	MD039356L	PA
3	2084P0800X	Psychiatry Physician	MD039356L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447294434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY B ZIMBERG MD

Provider Business Mailing Address
First Line	:	601 MEMORY LN
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-2231
Country	:	US
Telephone Number	:	717-851-1405
Fax Number	:	717-851-6969

Provider Business Practice Location Address
First Line	:	781 FAR HILLS DR
Second Line	:
City	:	NEW FREEDOM
State	:	PA
Zip	:	17349-8447
Country	:	US
Telephone Number	:	717-812-2560
Fax Number	:	717-812-2569

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

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	12/09/2024

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