Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 106081 | NY |
NPI | 1053534636 |
---|---|
Provider Name | Dr. Jonathan Zizmor |
First Address | New York, NY 10021-8501 |
Second Address | New York, NY 10021-8501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 08/07/2007 |