Provider Demographics
NPI:1093118804
Name:ZAITOUNA, IRENE JOSEPH (PHARMD)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:JOSEPH
Last Name:ZAITOUNA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 CLUB DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-6645
Mailing Address - Country:US
Mailing Address - Phone:248-703-8620
Mailing Address - Fax:
Practice Address - Street 1:2400 S TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0255
Practice Address - Country:US
Practice Address - Phone:248-409-1952
Practice Address - Fax:248-409-1962
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302040630183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist