Provider Demographics
NPI:1154324135
Name:ZIMBA, FRANK ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:ALLEN
Last Name:ZIMBA
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 1:286 COUNTY HIGHWAY 33
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-4728
Mailing Address - Country:US
Mailing Address - Phone:607-286-7933
Mailing Address - Fax:607-286-3837
Practice Address - Street 1:286 COUNTY HIGHWAY 33
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-4728
Practice Address - Country:US
Practice Address - Phone:716-640-1670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD054300L207T00000X
NY197137207T00000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01522476Medicaid
NY01522476Medicaid
RA1319Medicare ID - Type Unspecified