Provider Demographics
NPI:1124340542
Name:ZUCKERMAN, GILBERT L
Entity type:Individual
Prefix:MR
First Name:GILBERT
Middle Name:L
Last Name:ZUCKERMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6024 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4012
Mailing Address - Country:US
Mailing Address - Phone:718-439-4721
Mailing Address - Fax:718-492-9549
Practice Address - Street 1:6024 5TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4012
Practice Address - Country:US
Practice Address - Phone:718-439-4721
Practice Address - Fax:718-492-9549
Is Sole Proprietor?:No
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029387183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist