Provider Demographics
NPI:1043444763
Name:KAIZER, VICTOR ZON (BA,MA)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:ZON
Last Name:KAIZER
Suffix:
Gender:M
Credentials:BA,MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 WOODHAVEN RD APT C4
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19154-1730
Mailing Address - Country:US
Mailing Address - Phone:215-281-9315
Mailing Address - Fax:
Practice Address - Street 1:3201 WOODHAVEN RD APT C4
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19154-1730
Practice Address - Country:US
Practice Address - Phone:215-281-9315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-08
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities