MEDICARE: ANDREW ZIMMERMAN LCSW PLLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1962927590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDREW ZIMMERMAN LCSW PLLC

Provider Business Mailing Address
First Line	:	138 MACON ST APT 3
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-2205
Country	:	US
Telephone Number	:	888-517-4992
Fax Number	:	252-377-4231

Provider Business Practice Location Address
First Line	:	252 JAVA ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11222-5424
Country	:	US
Telephone Number	:	888-517-4992
Fax Number	:	252-377-4231

Authorized Official
Title or Position	:	OWNER
Name	:	ANDREW ZIMMERMAN
Credential	:	LCSW
Telephone Number	:	888-517-4992

Provider Enumeration Date	:	08/04/2017
Last Update Date	:	08/04/2017

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