Provider Demographics
NPI:1013075068
Name:ZIMM, ABRAHAM JOSHUA (MD)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:JOSHUA
Last Name:ZIMM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:A.
Other - Middle Name:JOSHUA
Other - Last Name:ZIMM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1421 3RD AVE
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-1802
Mailing Address - Country:US
Mailing Address - Phone:212-327-4600
Mailing Address - Fax:212-472-3086
Practice Address - Street 1:1421 3RD AVE
Practice Address - Street 2:4TH FLR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-1802
Practice Address - Country:US
Practice Address - Phone:212-327-4600
Practice Address - Fax:212-472-3086
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206767207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY379B81Medicare PIN
NYH41315Medicare UPIN
NYA400077068Medicare PIN