Provider Demographics
NPI:1548385537
Name:ZIMMERMAN, GAIL BETH (MD)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:BETH
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 MOUNT ST
Mailing Address - Street 2:
Mailing Address - City:BAY HEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-5361
Mailing Address - Country:US
Mailing Address - Phone:732-899-9440
Mailing Address - Fax:732-899-9441
Practice Address - Street 1:519 MAIN AVE
Practice Address - Street 2:
Practice Address - City:BAY HEAD
Practice Address - State:NJ
Practice Address - Zip Code:08742-4761
Practice Address - Country:US
Practice Address - Phone:732-899-9440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA058267207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ853181Medicare ID - Type Unspecified
NJG02854Medicare UPIN