Provider Demographics
NPI:1033188461
Name:SMALL, TZVI (MD)
Entity Type:Individual
Prefix:DR
First Name:TZVI
Middle Name:
Last Name:SMALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:TZVI
Other - Middle Name:
Other - Last Name:SMALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:535 SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4224
Mailing Address - Country:US
Mailing Address - Phone:732-741-0970
Mailing Address - Fax:201-599-1501
Practice Address - Street 1:275 FOREST AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-599-1500
Practice Address - Fax:201-599-1501
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA075552002086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ072014Medicare ID - Type Unspecified
NJH65710Medicare UPIN