Provider Demographics
NPI:1548374747
Name:KAZMOUZ, HASNA (MD)
Entity type:Individual
Prefix:
First Name:HASNA
Middle Name:
Last Name:KAZMOUZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 SHADY TER
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-4319
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7 LEE PL
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07505-1803
Practice Address - Country:US
Practice Address - Phone:973-742-1824
Practice Address - Fax:973-742-1818
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA72031207Q00000X
NY218273207Q00000X
FLME108236207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine