Provider Demographics
NPI:1124092010
Name:ZINAMAN, MICHAEL JAY (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAY
Last Name:ZINAMAN
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 1:1400 PELHAM PKWY S
Mailing Address - Street 2:RM BS26
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1138
Mailing Address - Country:US
Mailing Address - Phone:718-918-6300
Mailing Address - Fax:718-918-6318
Practice Address - Street 1:1400 PELHAM PKWY S
Practice Address - Street 2:RM BS26
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1138
Practice Address - Country:US
Practice Address - Phone:718-918-6300
Practice Address - Fax:718-918-6318
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY272853-1207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E53244Medicare UPIN
IL981380Medicare ID - Type Unspecified
ILL80455Medicare ID - Type Unspecified