Provider Demographics
NPI:1962661660
Name:EZRA S. KAZAM MD PA
Entity Type:Organization
Organization Name:EZRA S. KAZAM MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:EZRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KAZAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-267-8755
Mailing Address - Street 1:2 WASHINGTON PL
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-4220
Mailing Address - Country:US
Mailing Address - Phone:973-267-8755
Mailing Address - Fax:973-267-6265
Practice Address - Street 1:2 WASHINGTON PL
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-4220
Practice Address - Country:US
Practice Address - Phone:973-267-8755
Practice Address - Fax:973-267-6265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-06
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ32680332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0713100001Medicare NSC
C52647Medicare PIN