Provider Demographics
NPI:1336921428
Name:BAZZI, ZEINA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ZEINA
Middle Name:
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 1:25689 LOCH LOMOND DR
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48125-1073
Mailing Address - Country:US
Mailing Address - Phone:313-615-9399
Mailing Address - Fax:
Practice Address - Street 1:14715 FORD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-3040
Practice Address - Country:US
Practice Address - Phone:313-908-2212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302415630183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist