Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | P00232 | CT |
N | 111NR0200X | Radiology | P00232 | CT |
N | 213ER0200X | Radiology | P00232 | CT |
N | 2081S0010X | Sports Medicine | P00232 | CT |
N | 213ES0000X | Sports Medicine | P00232 | CT |
Y | 213ES0103X | Foot & Ankle Surgery | P00232 | CT |
N | 213ES0131X | Foot Surgery | P00232 | CT |
NPI | 1790857969 |
---|---|
Provider Name | Dr. Arnold Zuckman |
First Address | Bridgeport, CT 06606-5302 |
Second Address | Bridgeport, CT 06606-5302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 17/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004006763 | (05) | CT |
030000232CT01 | BLUE SHIELD (01) | CT |
060874388 | FEDERAL TAX ID (01) | CT |
1803438002 | CIGNA (01) | CT |
27-01372 | EVERCARE (01) | CT |
568061 | AETNA (01) | CT |
T22987 | (02) | CT |
ZS616 | OXFORD (01) | CT |