Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1809 | MA |
Y | 222Z00000X | Podiatrist | 1809 | MA |
NPI | 1073533147 |
---|---|
Provider Name | Brian John Zinsmeister |
First Address | Lexington, MA 02420-4646 |
Second Address | Lexington, MA 02420-4646 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0361577 | (05) | MA |
T58778 | (02) | MA |