Provider Demographics
NPI:1003066648
Name:ZIMMERMAN, ROSEMARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROSEMARIE
Middle Name:
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 W 58TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1530
Mailing Address - Country:US
Mailing Address - Phone:212-245-0055
Mailing Address - Fax:212-245-0994
Practice Address - Street 1:147 W 58TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1530
Practice Address - Country:US
Practice Address - Phone:212-245-0055
Practice Address - Fax:212-245-0994
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY347081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice