Provider Demographics
NPI:1124213202
Name:BRIAN J ZINSMEISTER
Entity Type:Organization
Organization Name:BRIAN J ZINSMEISTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLANIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-862-3953
Mailing Address - Street 1:76 BEDFORD ST STE 31
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-4641
Mailing Address - Country:US
Mailing Address - Phone:781-862-3953
Mailing Address - Fax:781-862-4306
Practice Address - Street 1:76 BEDFORD ST STE 31
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-4641
Practice Address - Country:US
Practice Address - Phone:781-862-3953
Practice Address - Fax:781-862-4306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1809213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY77203OtherBLUE CROSS BLUE SHIELD
MAM21359OtherMEDICARE
MA0495620001Medicare NSC