MEDICARE: DR. MARYAM KAZMI DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	25MB13074900	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972063055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARYAM KAZMI DO

Provider Business Mailing Address
First Line	:	3 UNIVERSITY PLZ STE 205
Second Line	:
City	:	HACKENSACK
State	:	NJ
Zip	:	07601-6208
Country	:	US
Telephone Number	:	201-833-3599
Fax Number	:	201-227-6207

Provider Business Practice Location Address
First Line	:	255 ROUTE 3 STE 107
Second Line	:
City	:	SECAUCUS
State	:	NJ
Zip	:	07094-3857
Country	:	US
Telephone Number	:	551-236-5550
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2019
Last Update Date	:	06/09/2026

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