Provider Demographics
NPI:1841385192
Name:ZAIDERMAN, ISIDORE NONE (DPM)
Entity type:Individual
Prefix:DR
First Name:ISIDORE
Middle Name:NONE
Last Name:ZAIDERMAN
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 1:1808 CONNECTICUT AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-5729
Mailing Address - Country:US
Mailing Address - Phone:202-332-3898
Mailing Address - Fax:202-387-7798
Practice Address - Street 1:1808 CONNECTICUT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-5729
Practice Address - Country:US
Practice Address - Phone:202-332-3898
Practice Address - Fax:202-387-7798
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCP0245213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC154134Medicare ID - Type UnspecifiedMEDICARE PARTICIPATION #
MD728RMedicare ID - Type UnspecifiedMEDICARE PARTICIPATING #