Provider Demographics
NPI:1710970553
Name:CHAZIN, NORMAN S (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:S
Last Name:CHAZIN
Suffix:
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 1:61A CENTRAL SQ
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-2167
Mailing Address - Country:US
Mailing Address - Phone:609-926-7001
Mailing Address - Fax:609-926-7004
Practice Address - Street 1:61A CENTRAL SQ
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-2167
Practice Address - Country:US
Practice Address - Phone:609-926-7001
Practice Address - Fax:609-926-7004
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA046021002084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
01041101408221A001OtherTRICARE
S00010411014OtherAETNA
000463720OtherHIGHMARK
0104110140OtherHORIZON BCBS
NJ1464400Medicaid
000463720OtherHIGHMARK
01041101408221A001OtherTRICARE