Active NPI
Michael Adam Izen, D.V.M.
- Veterinarian
- Closter, NJ
National Provider Identifier
1306154489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Veterinarian
- License
- 29VI00579400
- Practice address
- 137 Piermont Rd
Closter, NJ 07624-1518 - Phone
- (201) 768-0880
- NPI assigned
- Sep 22, 2010
- Last updated
- Jan 6, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Veterinarian | 174M00000X | 29VI00579400 | NJ | Primary |
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
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29VI00579400 | NJ | MD | Veterinarian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641427200000",
"number": "1306154489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 NORTHVIEW AVE APT 1",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070431809",
"telephone_number": "201-543-3206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "137 PIERMONT RD",
"city": "CLOSTER",
"state": "NJ",
"postal_code": "076241518",
"telephone_number": "201-768-0880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IZEN",
"first_name": "MICHAEL",
"middle_name": "ADAM",
"name_prefix": "Dr.",
"credential": "D.V.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-22",
"last_updated": "2022-01-06",
"certification_date": "2022-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "174M00000X",
"taxonomy_group": "",
"desc": "Veterinarian",
"state": "NJ",
"license": "29VI00579400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Closter, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.