Provider Demographics
NPI:1184603789
Name:ZUCKER, ROBERT SAMUEL (MD, MPH)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:SAMUEL
Last Name:ZUCKER
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 POND ST APT 10
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-2047
Mailing Address - Country:US
Mailing Address - Phone:781-806-0215
Mailing Address - Fax:781-806-0215
Practice Address - Street 1:63 POND ST APT 10
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067-2047
Practice Address - Country:US
Practice Address - Phone:781-806-0215
Practice Address - Fax:781-806-0215
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75495208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation