Provider Demographics
NPI:1629301189
Name:ZIMMERMAN, STEVEN ELI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ELI
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 AVENUE J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-3733
Mailing Address - Country:US
Mailing Address - Phone:718-338-4477
Mailing Address - Fax:718-799-1075
Practice Address - Street 1:2701 AVENUE J
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-3733
Practice Address - Country:US
Practice Address - Phone:718-338-4477
Practice Address - Fax:718-799-1075
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019066103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist