Individual
MR. ETAN HAZIZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, CCC-SLP
Contact information
Practice address
1 CEDAR CREST DR, POMPTON PLAINS, NJ 07444-2100
(973) 831-1369
Mailing address
142 POMPTON AVE, APT. 2, VERONA, NJ 07044-2936
(201) 452-0671
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00811500
NJ
Other
Enumeration date
03/21/2016
Last updated
03/21/2016
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