Provider Demographics
NPI:1922063684
Name:ZUCKERMAN, ANDREA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:LYNN
Last Name:ZUCKERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:84 HIGHGATE ST
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-4342
Mailing Address - Country:US
Mailing Address - Phone:781-444-3891
Mailing Address - Fax:
Practice Address - Street 1:800 WASHINGONT ST
Practice Address - Street 2:TUFTS-NEMC BOX 022
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1526
Practice Address - Country:US
Practice Address - Phone:617-636-5289
Practice Address - Fax:617-636-3295
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA74510207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3113710Medicaid
MADX2838Medicare PIN