Provider Demographics
NPI:1285626283
Name:AMIN-ZIMMERMAN, FALGUNI (MD)
Entity type:Individual
Prefix:
First Name:FALGUNI
Middle Name:
Last Name:AMIN-ZIMMERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FALGUNI
Other - Middle Name:
Other - Last Name:AMIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1401 HARRODSBURG RD
Mailing Address - Street 2:SUITE A-100
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3751
Mailing Address - Country:US
Mailing Address - Phone:859-258-6505
Mailing Address - Fax:859-258-6509
Practice Address - Street 1:1401 HARRODSBURG RD
Practice Address - Street 2:SUITE A-100
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3751
Practice Address - Country:US
Practice Address - Phone:859-258-6505
Practice Address - Fax:859-258-6509
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY413002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY4000501OtherMEDICARE LAB GROUP
OH2560974Medicaid
KY37903705OtherMEDICAID LAB GROUP
I27913Medicare UPIN
KY37903705OtherMEDICAID LAB GROUP
OH9338181Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
KY4000501OtherMEDICARE LAB GROUP
KY0098013Medicare PIN