Provider Demographics
NPI:1689258170
Name:AMBAR, NETA (DVM)
Entity Type:Individual
Prefix:DR
First Name:NETA
Middle Name:
Last Name:AMBAR
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 E IVANHOE PL APT 216
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1276
Mailing Address - Country:US
Mailing Address - Phone:781-801-4470
Mailing Address - Fax:
Practice Address - Street 1:2015 LINDEN DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53706-1100
Practice Address - Country:US
Practice Address - Phone:781-801-4470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI489849174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI489849OtherWISCONSIN STATE VETERINARY EXAMINING BOARD
BK4348795-438OtherDEA