Basic Information
| Provider Information | |||||||||
| NPI: | 1134326507 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COHEN | ||||||||
| FirstName: | ZIVIT | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | JAVETZ | ||||||||
| OtherFirstName: | ZIVIT | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 7125 ORCHARD LAKE RD STE 101 | ||||||||
| Address2: | |||||||||
| City: | WEST BLOOMFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483223616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488657481 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7125 ORCHARD LAKE RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | WEST BLOOMFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488657444 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2007 | ||||||||
| LastUpdateDate: | 02/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 4301083987 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.