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General NPI Number Information
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NPI Number | 1639216641
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Entity Type | Organization
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Legal Business Name | KAZA MEDICAL GROUP
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 12/05/2012
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Provider Practice Location Address
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Address Line | 18 OLD RUDNICK LN
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City | DOVER
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State | DE
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Zip | 19901-4912
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Country | US
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Telephone | 302-674-2616
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Fax | 302-883-8020
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Provider Business Mailing Address
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Address Line | 18 OLD RUDNICK LN
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City | DOVER
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State | DE
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Zip | 19901-4912
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Country | US
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Telephone | 302-674-2616
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Fax | 302-883-8020
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JANAKI KAZA
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Credential |
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Telephone | 302-674-2616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | C1-0009783
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | C1-0002870
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | C1-0D01490
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License Number State | DE
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