Healthcare Provider Details

I. General information

NPI: 1528074242
Provider Name (Legal Business Name): DR MAZ D.C.P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 CENTRAL AVE
MIDLAND PARK NJ
07432-1401
US

IV. Provider business mailing address

33 CENTRAL AVE
MIDLAND PARK NJ
07432-1401
US

V. Phone/Fax

Practice location:
  • Phone: 201-689-0800
  • Fax: 201-689-0871
Mailing address:
  • Phone: 201-689-0800
  • Fax: 201-689-0871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ALI MAZANDARANI
Title or Position: OWNER
Credential:
Phone: 201-819-1081