Provider Demographics
NPI:1952163636
Name:AVIVA, LLC
Entity Type:Organization
Organization Name:AVIVA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AVIVA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:484-340-0223
Mailing Address - Street 1:822 MONTGOMERY AVE STE 314
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-1948
Mailing Address - Country:US
Mailing Address - Phone:610-455-4254
Mailing Address - Fax:
Practice Address - Street 1:822 MONTGOMERY AVE STE 314
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-1948
Practice Address - Country:US
Practice Address - Phone:610-455-4254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty