Healthcare Provider Details

I. General information

NPI: 1285434456
Provider Name (Legal Business Name): EDEN MIZER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6305 AMES AVE
OMAHA NE
68104-2027
US

IV. Provider business mailing address

3854 SEWARD ST
OMAHA NE
68111-4043
US

V. Phone/Fax

Practice location:
  • Phone: 888-226-0111
  • Fax:
Mailing address:
  • Phone: 402-706-8247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: