Provider Demographics
NPI:1902331291
Name:ZIV, YONATAN MOSHE (MD)
Entity Type:Individual
Prefix:MR
First Name:YONATAN
Middle Name:MOSHE
Last Name:ZIV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 EAST 210TH STREET
Mailing Address - Street 2:BRONX
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10467
Mailing Address - Country:US
Mailing Address - Phone:718-920-6097
Mailing Address - Fax:718-920-8375
Practice Address - Street 1:111 EAST 210TH STREET
Practice Address - Street 2:BRONX
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-6097
Practice Address - Fax:718-920-8375
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2017-12-28
Deactivation Date:2017-11-27
Deactivation Code:
Reactivation Date:2017-12-28
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program