Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 25MA05384900 | NJ |
NPI | 1033376041 |
---|---|
Provider Name | Dr. Deena Rachel Zimmerman |
First Address | Teaneck, NJ 07666-5625 |
Second Address | Teaneck, NJ 07666-5625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2008 |
Last Update Date | 19/05/2008 |