Healthcare Provider Details

I. General information

NPI: 1063518462
Provider Name (Legal Business Name): COMMONWEALTH HEART CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 08/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7605 FOREST AVE SUITE 404
RICHMOND VA
23229-4938
US

IV. Provider business mailing address

7605 FOREST AVE SUITE 404
RICHMOND VA
23229-4938
US

V. Phone/Fax

Practice location:
  • Phone: 804-288-8257
  • Fax: 804-288-3917
Mailing address:
  • Phone: 804-288-8257
  • Fax: 804-288-3917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0101038086
License Number StateVA

VIII. Authorized Official

Name: DR. GARY REUBEN ZEEVI
Title or Position: PRESIDENT
Credential: MD
Phone: 804-288-8257