Provider Demographics
NPI:1164420535
Name:ZUCKERMAN, DONALD (MSW)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:ZUCKERMAN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6827 4TH ST NW
Mailing Address - Street 2:APT 106
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-1922
Mailing Address - Country:US
Mailing Address - Phone:202-483-2660
Mailing Address - Fax:202-882-6868
Practice Address - Street 1:3000 CONNECTICUT AVE NW
Practice Address - Street 2:STE 301
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2531
Practice Address - Country:US
Practice Address - Phone:202-483-2660
Practice Address - Fax:202-882-6868
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3029731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC491825Medicare ID - Type Unspecified