Provider Demographics
NPI:1518012509
Name:ZINNER, TRACY REBECCA (MD)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:REBECCA
Last Name:ZINNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TRACY
Other - Middle Name:REBECCA
Other - Last Name:WHITENER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD,
Mailing Address - Street 1:1 BROOKLINE PL STE 620
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7296
Mailing Address - Country:US
Mailing Address - Phone:617-735-8800
Mailing Address - Fax:617-278-9358
Practice Address - Street 1:1 BROOKLINE PL
Practice Address - Street 2:SUITE, 521
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7224
Practice Address - Country:US
Practice Address - Phone:617-735-8800
Practice Address - Fax:617-278-9358
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA212991207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0026961OtherNEIGHBORHOOD HEALTH PLAN
MA0179591Medicaid
MA131624OtherHARVARD PILGRIM
MA405183OtherTUFTS
MAJ24926OtherBLUE CROSS BLUE SHIELD
MA0179591Medicaid