Provider Demographics
NPI:1043281496
Name:ZUCKERMAN, ROBERT M (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:ZUCKERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 LINGLESTOWN RD
Mailing Address - Street 2:SUITE 160-A
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-9499
Mailing Address - Country:US
Mailing Address - Phone:717-541-8066
Mailing Address - Fax:717-671-9157
Practice Address - Street 1:2151 LINGLESTOWN RD
Practice Address - Street 2:SUITE 160-A
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-9499
Practice Address - Country:US
Practice Address - Phone:717-541-8066
Practice Address - Fax:717-671-9157
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMDO39714-L207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001133600Medicaid
PA001133600Medicaid
PA085435ZBDMMedicare PIN