Provider Demographics
NPI:1427401207
Name:ADAM RAUZMAN D.D.S.
Entity Type:Organization
Organization Name:ADAM RAUZMAN D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-427-4201
Mailing Address - Street 1:911 LINCOLN AVE
Mailing Address - Street 2:APARTMENT #2
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-3226
Mailing Address - Country:US
Mailing Address - Phone:201-960-2859
Mailing Address - Fax:
Practice Address - Street 1:164 WARBURTON AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NJ
Practice Address - Zip Code:07506-2552
Practice Address - Country:US
Practice Address - Phone:973-427-4201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02641000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty