Healthcare Provider Details

I. General information

NPI: 1710970553
Provider Name (Legal Business Name): NORMAN S CHAZIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61A CENTRAL SQ
LINWOOD NJ
08221-2167
US

IV. Provider business mailing address

61A CENTRAL SQ
LINWOOD NJ
08221-2167
US

V. Phone/Fax

Practice location:
  • Phone: 609-926-7001
  • Fax: 609-926-7004
Mailing address:
  • Phone: 609-926-7001
  • Fax: 609-926-7004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number25MA04602100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: