Provider Demographics
NPI:1568596773
Name:ZAZZALI, GEORGE NICHOLAS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:NICHOLAS
Last Name:ZAZZALI
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 FRANKLIN AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1259
Mailing Address - Country:US
Mailing Address - Phone:973-846-7034
Mailing Address - Fax:
Practice Address - Street 1:670 FRANKLIN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-1259
Practice Address - Country:US
Practice Address - Phone:973-846-7034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA00063735207R00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation