Provider Demographics
NPI:1447294434
Name:ZIMBERG, GARY B (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:B
Last Name:ZIMBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:781 FAR HILLS DR
Practice Address - Street 2:
Practice Address - City:NEW FREEDOM
Practice Address - State:PA
Practice Address - Zip Code:17349-8447
Practice Address - Country:US
Practice Address - Phone:717-812-2560
Practice Address - Fax:717-812-2569
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039356L2084P0802X, 2084P0805X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001565105Medicaid
PA56587OtherPA BKUE SHIELD
PAIP016306OtherMAGELLAN
PA001565105Medicaid
PA260041335OtherMEDICARE RAILROAD
PA001259OtherVALUE OPTIONS
PA01143001OtherCAPITAL BLUE CROSS
PA2109087OtherCIGNA BEAHVIORAL HEALTH
PA342236OtherMAMSI
PA001565105Medicaid
PAIP016306OtherMAGELLAN