Provider Demographics
NPI:1316142979
Name:KAZAM, TAL MANOR (MD)
Entity type:Individual
Prefix:DR
First Name:TAL
Middle Name:MANOR
Last Name:KAZAM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1090 AMSTERDAM AVE
Mailing Address - Street 2:SUITE 9A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1737
Mailing Address - Country:US
Mailing Address - Phone:212-662-0399
Mailing Address - Fax:212-662-0259
Practice Address - Street 1:160 BOSTON AVE # 32701
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-4798
Practice Address - Country:US
Practice Address - Phone:407-775-7654
Practice Address - Fax:407-339-1203
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2023-10-20
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Provider Licenses
StateLicense IDTaxonomies
NY241933207W00000X
FLME154830207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology