Provider Demographics
NPI:1790380293
Name:KAZ MANAGEMENT LLC
Entity Type:Organization
Organization Name:KAZ MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:AL MUNTASER
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZ KAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-836-7575
Mailing Address - Street 1:23450 ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-2242
Mailing Address - Country:US
Mailing Address - Phone:248-836-7575
Mailing Address - Fax:
Practice Address - Street 1:23450 ONEIDA ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-2242
Practice Address - Country:US
Practice Address - Phone:248-836-7575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No347C00000XTransportation ServicesPrivate Vehicle