Provider Demographics
NPI:1154539492
Name:ZIMMERMAN, THOMAS ROBERT JR (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ROBERT
Last Name:ZIMMERMAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:230 MENDHAM RD
Mailing Address - Street 2:
Mailing Address - City:BERNARDSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07924-1626
Mailing Address - Country:US
Mailing Address - Phone:908-766-0750
Mailing Address - Fax:908-766-4870
Practice Address - Street 1:80 MORRISTOWN RD
Practice Address - Street 2:SUITE 302
Practice Address - City:BERNARDSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07924-2313
Practice Address - Country:US
Practice Address - Phone:908-766-0750
Practice Address - Fax:908-766-4870
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207RG0300X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Not Answered2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ53F98OtherNJ-BLUE SHIELD
NJ58114386BOtherWELFARE
NJ1221906Medicaid
NJE52646Medicare UPIN
NJ1221906Medicaid