Provider Demographics
NPI:1982268678
Name:ZEN, FENNY (MD)
Entity Type:Individual
Prefix:DR
First Name:FENNY
Middle Name:
Last Name:ZEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3463 STONEVISTA LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-4942
Mailing Address - Country:US
Mailing Address - Phone:614-632-6560
Mailing Address - Fax:
Practice Address - Street 1:320 CENTER ST
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024
Practice Address - Country:US
Practice Address - Phone:440-285-8585
Practice Address - Fax:440-285-3754
Is Sole Proprietor?:No
Enumeration Date:2019-04-28
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.145703207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35.145703OtherOHIO MEDICAL ELICENSURE
OH0492830Medicaid