Provider Demographics
NPI:1881674208
Name:ZIMAN, LINDA G (DPM)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:G
Last Name:ZIMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 GLEN ECHO RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-2918
Mailing Address - Country:US
Mailing Address - Phone:215-561-3668
Mailing Address - Fax:
Practice Address - Street 1:624 GLEN ECHO RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-2918
Practice Address - Country:US
Practice Address - Phone:215-561-3668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002922L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1008854Medicaid
PA1008854Medicaid
PA148621Medicare PIN