Provider Demographics
NPI:1326215435
Name:VAZAN, DAVID FRIDRICH (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:FRIDRICH
Last Name:VAZAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6 TSIENNETO RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-1584
Mailing Address - Country:US
Mailing Address - Phone:603-434-4193
Mailing Address - Fax:603-437-6804
Practice Address - Street 1:6 TSIENNETO RD
Practice Address - Street 2:SUITE 101
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1584
Practice Address - Country:US
Practice Address - Phone:603-434-4193
Practice Address - Fax:603-437-6804
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2013-05-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY245924207W00000X
NJ25MA08438700207W00000X
NH15115207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology