Provider Demographics
NPI:1255684023
Name:NORMAN CHAZIN MD LLC
Entity type:Organization
Organization Name:NORMAN CHAZIN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAZIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-705-3221
Mailing Address - Street 1:199 NEW RD STE 61A
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-2029
Mailing Address - Country:US
Mailing Address - Phone:609-926-7001
Mailing Address - Fax:609-926-7004
Practice Address - Street 1:199 NEW RD STE 61A
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-2029
Practice Address - Country:US
Practice Address - Phone:609-926-7001
Practice Address - Fax:609-926-7004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA046021002084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
463720OtherMEDICARE PTAN