Provider Demographics
NPI:1447417795
Name:MOREEN, TZIVIA (MD)
Entity Type:Individual
Prefix:DR
First Name:TZIVIA
Middle Name:
Last Name:MOREEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 MORGAN ST STE 105
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5436
Mailing Address - Country:US
Mailing Address - Phone:203-276-2516
Mailing Address - Fax:203-276-2515
Practice Address - Street 1:90 MORGAN ST STE 105
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5436
Practice Address - Country:US
Practice Address - Phone:203-276-2516
Practice Address - Fax:203-276-2515
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT51203207RG0300X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine