MEDICARE: DR. STEVEN ELI ZIMMERMAN PSY.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	103T00000X	Psychologist	019066	NY

General Provider Information

NPI Number	:	1629301189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN ELI ZIMMERMAN PSY.D.

Provider Business Mailing Address
First Line	:	2701 AVENUE J
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-3733
Country	:	US
Telephone Number	:	718-338-4477
Fax Number	:	718-799-1075

Provider Business Practice Location Address
First Line	:	2701 AVENUE J
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-3733
Country	:	US
Telephone Number	:	718-338-4477
Fax Number	:	718-799-1075

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

Provider Enumeration Date	:	09/15/2009
Last Update Date	:	04/28/2011

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