Provider Demographics
NPI:1497757082
Name:ZIVE PHARMACY
Entity Type:Organization
Organization Name:ZIVE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:ZIVE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:718-824-6060
Mailing Address - Street 1:811 LYDIG AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-2105
Mailing Address - Country:US
Mailing Address - Phone:718-824-6060
Mailing Address - Fax:718-824-1568
Practice Address - Street 1:811 LYDIG AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-2105
Practice Address - Country:US
Practice Address - Phone:718-824-6060
Practice Address - Fax:718-824-1568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009833333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00260095Medicaid
NY0349770001Medicare ID - Type Unspecified