Provider Demographics
NPI:1225015662
Name:ZENT, CLIVE S (MD)
Entity Type:Individual
Prefix:
First Name:CLIVE
Middle Name:S
Last Name:ZENT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 704
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-273-5823
Mailing Address - Fax:585-273-1051
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX 704
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-273-5823
Practice Address - Fax:585-273-1051
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY272917207RH0000X
MN45639207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN627615600Medicaid
MN627615600Medicaid
MNP00004045Medicare ID - Type UnspecifiedRAILROAD
MN820000030Medicare ID - Type Unspecified