Provider Demographics
NPI:1508426891
Name:ZAN, MOHAMMAD (OD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:
Last Name:ZAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4733 US HIGHWAY 9 UNIT 100
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-4020
Mailing Address - Country:US
Mailing Address - Phone:732-901-4158
Mailing Address - Fax:
Practice Address - Street 1:4733 HWY 9 STE 100
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-4020
Practice Address - Country:US
Practice Address - Phone:732-901-4158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00687800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist