Provider Demographics
NPI:1417150608
Name:HOWARD M. ZINMAN, M.D., P.C.
Entity Type:Organization
Organization Name:HOWARD M. ZINMAN, M.D., P.C.
Other - Org Name:WEST SIDE PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZINMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-856-0200
Mailing Address - Street 1:299 LINCOLN ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3646
Mailing Address - Country:US
Mailing Address - Phone:508-856-0200
Mailing Address - Fax:508-856-0222
Practice Address - Street 1:299 LINCOLN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3646
Practice Address - Country:US
Practice Address - Phone:508-856-0200
Practice Address - Fax:508-856-0222
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOWARD M. ZINMAN, M.D., P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-06
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA153204208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty