Provider Demographics
NPI:1629798244
Name:KAZAN, ROY (MD, PHD, FRCSC)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:
Last Name:KAZAN
Suffix:
Gender:M
Credentials:MD, PHD, FRCSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 WATERFRONT PL APT 206
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-5707
Mailing Address - Country:US
Mailing Address - Phone:413-304-6516
Mailing Address - Fax:
Practice Address - Street 1:3380 BOULEVARD OF THE ALLIES STE 158
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3125
Practice Address - Country:US
Practice Address - Phone:412-641-6308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4789402086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery