Healthcare Provider Details

I. General information

NPI: 1871963918
Provider Name (Legal Business Name): ZDOROVIE SENIOR SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2015
Last Update Date: 10/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149A CALIFORNIA ST
NEWTON MA
02458-1023
US

IV. Provider business mailing address

149A CALIFORNIA ST
NEWTON MA
02458-1023
US

V. Phone/Fax

Practice location:
  • Phone: 617-795-0947
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MAX MAZAEV
Title or Position: PRESIDENT
Credential:
Phone: 617-953-4152