Provider Demographics
NPI:1548406499
Name:KAZAN, YANAL
Entity Type:Individual
Prefix:
First Name:YANAL
Middle Name:
Last Name:KAZAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 CHAMBERLAIN AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07522-1031
Mailing Address - Country:US
Mailing Address - Phone:973-942-1212
Mailing Address - Fax:973-942-0523
Practice Address - Street 1:470 CHAMBERLAIN AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07522-1031
Practice Address - Country:US
Practice Address - Phone:973-942-1212
Practice Address - Fax:973-942-0523
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-24
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00233300111N00000X
NYX003425-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor