Provider Demographics
NPI:1659036333
Name:KAZAR, JAMIE (PA)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:KAZAR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:10 FERRY ST STE 302
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5081
Mailing Address - Country:US
Mailing Address - Phone:603-526-4635
Mailing Address - Fax:603-526-2151
Practice Address - Street 1:798 ROUTE 302
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05641-2305
Practice Address - Country:US
Practice Address - Phone:802-744-0138
Practice Address - Fax:802-622-0836
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-08
Last Update Date:2022-10-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VT055.0031592363A00000X
SC4198363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant