Provider Demographics
NPI:1750180543
Name:PAZ, XIOMARA D
Entity type:Individual
Prefix:
First Name:XIOMARA
Middle Name:D
Last Name:PAZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 4TH ST APT 3D
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07660-1063
Mailing Address - Country:US
Mailing Address - Phone:201-936-1763
Mailing Address - Fax:
Practice Address - Street 1:150 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-5950
Practice Address - Country:US
Practice Address - Phone:201-955-0354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTD3991156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician