1346343878 NPI number — ROBERT JAY ZENDLER II DO PC

Table of content: (NPI 1346343878)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346343878 NPI number — ROBERT JAY ZENDLER II DO PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT JAY ZENDLER II DO PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
VALLEY EYE CONSULTANTS PC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346343878
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1335 S LINDEN RD
Provider Second Line Business Mailing Address:
SUITE E
Provider Business Mailing Address City Name:
FLINT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48532
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-733-5535
Provider Business Mailing Address Fax Number:
810-733-1076

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1335 S LINDEN RD
Provider Second Line Business Practice Location Address:
SUITE E
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48532
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-733-5535
Provider Business Practice Location Address Fax Number:
810-733-1076
Provider Enumeration Date:
09/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ZENDLER
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
JAY
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
810-733-5535

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  5101009018 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 202136 . This is a "MCLAREN HEALTH PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 205340 . This is a "COLE MANAGED VISION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4087251 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1852509745 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1992122 . This is a "MOLINA HEALTH CARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: P60055 . This is a "BLUE CARE NETWORK" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 5250974 , issued by the state of ( MI ) . This identifiers is of the category "MEDICARE PIN".
  • Identifier: CE1334 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 5250974502 . This is a "HEALTH PLUS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 180007000 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: C2207 . This is a "M-CARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: OP44480 , issued by the state of ( MI ) . This identifiers is of the category "MEDICARE PIN".
  • Identifier: 144297 . This is a "SELECTCARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: F07167 . This is a "HEALTH ALLIANCE PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 3857130001 , issued by the state of ( MI ) . This identifiers is of the category "MEDICARE NSC".
  • Identifier: 105249 . This is a "CARE CHOICES" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: F07167 . This identifiers is of the category "MEDICARE UPIN".
  • Identifier: 1992122 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 202136 . This is a "HEALTH ADVANTAGE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 5250974 . This is a "MEDICARE PLUS BLUE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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