Individual
THERESA A. ZIMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
819 S SALINA ST, SYRACUSE, NY 13202-3536
(315) 476-7921
(315) 475-1448
Mailing address
819 S SALINA ST, SYRACUSE, NY 13202-3536
(315) 476-7921
(315) 474-1448
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F380579
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01550027
—
NY
Enumeration date
04/06/2006
Last updated
03/30/2016
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