Provider Demographics
NPI:1457307951
Name:ZIGMAN, STEPHEN (OD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:ZIGMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5922
Mailing Address - Country:US
Mailing Address - Phone:732-842-9177
Mailing Address - Fax:732-842-3970
Practice Address - Street 1:370 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5922
Practice Address - Country:US
Practice Address - Phone:732-842-9177
Practice Address - Fax:732-842-3970
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ00350700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0165204Medicaid
NJT81456Medicare UPIN
NJ0532880001Medicare NSC
NJ0165204Medicaid