| Doctor Name: | DR. MICHAEL ADAM IZEN |
| NPI Number: | 1306154489 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.V.M. |
| License Number: | 29VI00579400 |
| Business Practice Address: | 137 Piermont Rd Closter, NJ - 076241518 |
| Business Phone Number: | 2017680880 |
| Business Fax Number: | |
| Mailing Address: | 514 Knickerbocker Rd, TENAFLY |
| State: | NJ |
| Postal Code: | 076701417 |
| Phone Number: | 2015433206 |
| Fax Number: | |
| NPI Enumeration Date: | 09/22/2010 |
| NPI Last Update Date: | 09/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174M00000X |
| License Number: | 29VI00579400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Veterinarian |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A doctor of veterinary medicine, trained and authorized to practice veterinarian medicine and surgery. |