Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MDO39714-L | PA |
NPI | 1043281496 |
---|---|
Provider Name | Dr. Robert M Zuckerman |
First Address | Harrisburg, PA 17110-9499 |
Second Address | Harrisburg, PA 17110-9499 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 11/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001133600 | (05) | PA |
C29374 | (02) | PA |