Provider Demographics
NPI:1083675789
Name:KAIZEN, STEPHEN G
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:G
Last Name:KAIZEN
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:KAIZEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:O D
Mailing Address - Street 1:10 S CLINTON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-4220
Mailing Address - Country:US
Mailing Address - Phone:215-348-8030
Mailing Address - Fax:215-348-8030
Practice Address - Street 1:10 S CLINTON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4220
Practice Address - Country:US
Practice Address - Phone:215-348-8030
Practice Address - Fax:215-348-8030
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000925152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist