Provider Demographics
NPI:1245861400
Name:BAZZI, ZEINAB H (PHARMD)
Entity type:Individual
Prefix:
First Name:ZEINAB
Middle Name:H
Last Name:BAZZI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6803 PINEHURST ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1921
Mailing Address - Country:US
Mailing Address - Phone:313-408-9604
Mailing Address - Fax:
Practice Address - Street 1:10335 W WARREN AVE
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-1658
Practice Address - Country:US
Practice Address - Phone:313-581-4010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302042886183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist