Healthcare Provider Details

I. General information

NPI: 1639320021
Provider Name (Legal Business Name): BENJAMIN E ZORENSKY N.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2008
Last Update Date: 10/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 W WARNER RD 104
TEMPE AZ
85284-2965
US

IV. Provider business mailing address

430 W WARNER RD
TEMPE AZ
85284-2965
US

V. Phone/Fax

Practice location:
  • Phone: 480-785-0750
  • Fax: 480-785-0751
Mailing address:
  • Phone: 480-785-0750
  • Fax: 480-785-0751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number07-1034
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: