Provider Demographics
NPI:1750759411
Name:ZIMCOSKY, DAVID ANTHONY (PA-C)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ANTHONY
Last Name:ZIMCOSKY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 EUCLID AVE # A-40
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-3736
Mailing Address - Country:US
Mailing Address - Phone:216-218-1723
Mailing Address - Fax:216-445-3385
Practice Address - Street 1:4500 EUCLID AVE # A-40
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-3736
Practice Address - Country:US
Practice Address - Phone:216-476-7312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004526RX207X00000X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery