Healthcare Provider Details

I. General information

NPI: 1750609855
Provider Name (Legal Business Name): JAMES JACOB KAZAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JACOB KAZAM M.D.

II. Dates (important events)

Enumeration Date: 05/13/2010
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E. 68TH STREET, BOX 141
NEW YORK NY
10065-4885
US

IV. Provider business mailing address

575 LEXINGTON AVE RM 540
NEW YORK NY
10022-6145
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-6000
  • Fax: 646-962-0122
Mailing address:
  • Phone: 212-746-6000
  • Fax: 646-962-0122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number262585
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME182695
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: