Michael Adam Izen, D.V.M.
Individual provider Active NPI Veterinarian · Closter, NJ
NPI 1306154489 · NPPES record last updated Jan 6, 2022
Key facts
- NPI
- 1306154489
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Veterinarian 174M00000X
- License
- 29VI00579400 (NJ)
- Practice address
- 137 Piermont Rd
Closter, NJ 07624-1518 - Phone
- (201) 768-0880
- NPI assigned
- Sep 22, 2010
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29VI00579400 | NJ | MD | Veterinarian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Veterinarian | 174M00000X | 29VI00579400 | NJ | Yes |
Addresses
Primary practice location
137 Piermont Rd
Closter, NJ 07624-1518
Mailing address
20 Northview Ave Apt 1
Montclair, NJ 07043-1809
Phone (201) 543-3206
Other providers in Closter, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.