MEDICARE: LEONARD ZIMMERMAN 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	207R00000X	Internal Medicine Physician	1064351	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	W07721	OTHER		MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	M101118	OTHER	AETNA/USHC
2	0009322	OTHER	GHI
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	M4473575	OTHER	AETNA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962496935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEONARD ZIMMERMAN MD

Provider Business Mailing Address
First Line	:	20 GRAND ST
Second Line	:	3RD FLOOR
City	:	WARWICK
State	:	NY
Zip	:	10990-1035
Country	:	US
Telephone Number	:	845-987-3952
Fax Number	:	845-987-5979

Provider Business Practice Location Address
First Line	:	2 CROSFIELD AVE
Second Line	:	SUITE 318
City	:	WEST NYACK
State	:	NY
Zip	:	10994-2226
Country	:	US
Telephone Number	:	845-353-5600
Fax Number	:	845-353-5668

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	03/15/2011

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