Provider Demographics
NPI:1447278387
Name:ROBERT A ZIMMER DPM PC
Entity type:Organization
Organization Name:ROBERT A ZIMMER DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:716-366-6393
Mailing Address - Street 1:614 CENTRAL AVE
Mailing Address - Street 2:P O BOX 568
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-2539
Mailing Address - Country:US
Mailing Address - Phone:716-366-6393
Mailing Address - Fax:716-366-6394
Practice Address - Street 1:614 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-2539
Practice Address - Country:US
Practice Address - Phone:716-366-6393
Practice Address - Fax:716-366-6394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003623-1213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY50596AMedicare ID - Type Unspecified
NY1194140001Medicare NSC