Most Relevant Information
Provider Data
| NPI Number: | 1003365289 |
| Provider Name: | JUSTIN KAZIM |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 326826 |
Most Important Dates
| Enumeration Date: | 09/28/2016 |
| Last Updated: | 09/29/2016 |
Provider Practice Location
9402 VANDERVEER ST
QUEENS VILLAGE
NY
114281731
Practice Location Phone/Fax
| Phone: | 7186596225 |
| Fax: |
Provider Mailing Location
9402 VANDERVEER ST
QUEENS VILLAGE
NY
114281731
Provider Mailing Phone/Fax
| Phone: | 7186596225 |
| Fax: |