Provider Demographics
NPI:1750609855
Name:KAZAM, JAMES JACOB (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JACOB
Last Name:KAZAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JACOB
Other - Middle Name:
Other - Last Name:KAZAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:575 LEXINGTON AVENUE, SUITE 540
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-6102
Mailing Address - Country:US
Mailing Address - Phone:212-746-6000
Mailing Address - Fax:646-962-0122
Practice Address - Street 1:525 E. 68TH STREET, BOX 141
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4885
Practice Address - Country:US
Practice Address - Phone:212-746-6000
Practice Address - Fax:646-962-0122
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY2625852085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program