Active NPI
Jonathan Zizmor, M.D.
- Dermatology Physician
- New York, NY
National Provider Identifier
1053534636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 106081
- Practice address
- 1017 3Rd Ave
Second Floor
New York, NY 10021-8501 - Phone
- (212) 688-8326
- Fax
- (212) 688-8716
- NPI assigned
- Apr 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 106081 | NY | Primary |
Addresses
Primary practice location
1017 3Rd Ave
Second Floor
New York, NY 10021-8501
Mailing address
1017 3Rd Ave
Second Floor
New York, NY 10021-8501
Phone (212) 688-8326
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106081 | NY | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053534636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1017 3RD AVE",
"address_2": "SECOND FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100218501",
"telephone_number": "212-688-8326",
"fax_number": "212-688-8716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1017 3RD AVE",
"address_2": "SECOND FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100218501",
"telephone_number": "212-688-8326",
"fax_number": "212-688-8716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIZMOR",
"first_name": "JONATHAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "106081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.