Basic Information
Provider Information
NPI: 1003803206
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AVINER
FirstName: ZVI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4313 I 49 S SERVICE RD
Address2:  
City: OPELOUSAS
State: LA
PostalCode: 705700755
CountryCode: US
TelephoneNumber: 3379422024
FaxNumber: 3379486216
Practice Location
Address1: 4313 I 49 S SERVICE RD
Address2:  
City: OPELOUSAS
State: LA
PostalCode: 705700755
CountryCode: US
TelephoneNumber: 3379422024
FaxNumber: 3379486216
Other Information
ProviderEnumerationDate: 10/03/2005
LastUpdateDate: 12/13/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000X04266RLAN Other Service ProvidersSpecialist 
207W00000X04266RLAY193400000X MULTIPLE SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOphthalmology 

ID Information
IDTypeStateIssuerDescription
154909605LA MEDICAID


Home