Provider Demographics
NPI:1205237344
Name:ZIMAK, ERIC H (PHD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:H
Last Name:ZIMAK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CENTER FOR NEUROPSYCHOLOGICAL SERVICES
Mailing Address - Street 2:MSC 09 5030, 1 UNIVERSITY OF NEW MEXICO
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-8833
Mailing Address - Fax:505-272-8316
Practice Address - Street 1:CENTER FOR NEUROPSYCHOLOGICAL SERVICES
Practice Address - Street 2:MSC 09 5030, 1 UNIVERSITY OF NEW MEXICO
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-8833
Practice Address - Fax:505-272-8316
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM1346103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist