1700059201 NPI number — DR. JAMES KUPER ZIMMERMAN PH.D.

Table of content: DR. JAMES KUPER ZIMMERMAN PH.D. (NPI 1700059201)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700059201 NPI number — DR. JAMES KUPER ZIMMERMAN PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZIMMERMAN
Provider First Name:
JAMES
Provider Middle Name:
KUPER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700059201
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
61 ACADEMY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLEASANTVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10570-2023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-741-6240
Provider Business Mailing Address Fax Number:
914-741-6240

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
61 ACADEMY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLEASANTVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10570-2023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-741-6240
Provider Business Practice Location Address Fax Number:
914-741-6240
Provider Enumeration Date:
04/07/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  010118 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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