Provider Demographics
NPI:1013956143
Name:ZIMMERMAN, JOHN F JR (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:ZIMMERMAN
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 S NEW YORK RD
Mailing Address - Street 2:SUITE B7
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9680
Mailing Address - Country:US
Mailing Address - Phone:609-652-6363
Mailing Address - Fax:609-652-6949
Practice Address - Street 1:48 S NEW YORK RD
Practice Address - Street 2:SUITE B7
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9680
Practice Address - Country:US
Practice Address - Phone:609-652-6363
Practice Address - Fax:609-652-6949
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC03604111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ746703Medicare ID - Type UnspecifiedMEDICARE