Provider Demographics
NPI:1225823867
Name:PAZ, EVELYN
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:PAZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 SICOMAC RD STE 305
Mailing Address - Street 2:
Mailing Address - City:NORTH HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-2954
Mailing Address - Country:US
Mailing Address - Phone:973-348-6004
Mailing Address - Fax:
Practice Address - Street 1:33 SICOMAC RD STE 305
Practice Address - Street 2:
Practice Address - City:NORTH HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-2954
Practice Address - Country:US
Practice Address - Phone:973-348-6004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
NJ44SL07186200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty