Provider Demographics
NPI:1912097676
Name:ZUCKERMAN, PERRY PHILIP (MD)
Entity type:Individual
Prefix:DR
First Name:PERRY
Middle Name:PHILIP
Last Name:ZUCKERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12044 TURTLE SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91326-3836
Mailing Address - Country:US
Mailing Address - Phone:818-831-7859
Mailing Address - Fax:818-831-9439
Practice Address - Street 1:12044 TURTLE SPRINGS LN
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91326-3836
Practice Address - Country:US
Practice Address - Phone:818-831-7859
Practice Address - Fax:818-831-9439
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG551012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry