Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 0296731 | NY |
NPI | 1073512612 |
---|---|
Provider Name | Dr. Philip Zimring |
First Address | Woodmere, NY 11598-1218 |
Second Address | Woodmere, NY 11598-1218 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2005 |
Last Update Date | 08/07/2007 |