Provider Demographics
NPI:1518971399
Name:NESTELBAUM, ZAMIR (MD)
Entity Type:Individual
Prefix:DR
First Name:ZAMIR
Middle Name:
Last Name:NESTELBAUM
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 1:338 HIGHLAND ST
Mailing Address - Street 2:NEWTON SQUARE COUNSELING CENTER
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-2143
Mailing Address - Country:US
Mailing Address - Phone:508-752-5880
Mailing Address - Fax:508-831-9967
Practice Address - Street 1:338 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-2143
Practice Address - Country:US
Practice Address - Phone:508-752-5880
Practice Address - Fax:508-831-9967
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA591602084P0800X
NY1504792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3033848Medicaid
MA51398OtherHEALTH NEW ENGLAND
MA3033848Medicaid
MAJ07316Medicare Oscar/Certification
MA51398OtherHEALTH NEW ENGLAND
MAJ0731605Medicare PIN