Individual
JAROSLAV ZIVNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF GASTROENTEROLOGY, WORCESTER, MA 01655-0002
(508) 856-8399
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
209607
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110040645A
—
MA
Enumeration date
11/23/2005
Last updated
10/28/2020
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