Provider Demographics
NPI:1700179538
Name:ZUKERMAN, RAYMOND (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:ZUKERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CHARLES WAY
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-2736
Mailing Address - Country:US
Mailing Address - Phone:516-626-2494
Mailing Address - Fax:516-626-0959
Practice Address - Street 1:7 CHARLES WAY
Practice Address - Street 2:
Practice Address - City:GLEN HEAD
Practice Address - State:NY
Practice Address - Zip Code:11545-2736
Practice Address - Country:US
Practice Address - Phone:516-626-2494
Practice Address - Fax:516-626-0959
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY102569207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine