Provider Demographics
NPI:1801919741
Name:ZIMMERMAN, DANIEL JEFFREY (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JEFFREY
Last Name:ZIMMERMAN
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 1:128 E FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-1116
Mailing Address - Country:US
Mailing Address - Phone:856-313-9195
Mailing Address - Fax:
Practice Address - Street 1:100 KINGS WAY E
Practice Address - Street 2:WASHINGTON PAVILLION SUITE D 3
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2237
Practice Address - Country:US
Practice Address - Phone:856-589-1440
Practice Address - Fax:856-589-4616
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04234200207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine