Provider Demographics
NPI:1437197290
Name:ZIMMERMAN, ERIK E (MD)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:E
Last Name:ZIMMERMAN
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 1:1109 GRANBY ROAD
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-1969
Mailing Address - Country:US
Mailing Address - Phone:413-523-0900
Mailing Address - Fax:413-523-0901
Practice Address - Street 1:1109 GRANBY ROAD
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-1969
Practice Address - Country:US
Practice Address - Phone:413-523-0900
Practice Address - Fax:413-523-0901
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA470892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0129038Medicaid
MAB99546Medicare UPIN
MA0129038Medicaid