Provider Demographics
NPI:1568441301
Name:ZUCKER, ROBERT DICKSON (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DICKSON
Last Name:ZUCKER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7209 BUCKLEY RD
Mailing Address - Street 2:SUITE 1S
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-3807
Mailing Address - Country:US
Mailing Address - Phone:313-452-2800
Mailing Address - Fax:315-452-2801
Practice Address - Street 1:7209 BUCKLEY RD
Practice Address - Street 2:SUITE 1S
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-3807
Practice Address - Country:US
Practice Address - Phone:313-452-2800
Practice Address - Fax:315-452-2801
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002348213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT-26265Medicare UPIN
CC8635Medicare ID - Type Unspecified