Individual
DR. FAZAL R PANEZAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
177 MAIN STREET, MATAWAN, NJ 07747
(732) 566-6614
(732) 290-9448
Mailing address
177 MAIN ST, MATAWAN, NJ 07747-3127
(732) 566-6614
(732) 290-9448
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA03349200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2066602-22
—
NJ
Enumeration date
10/19/2006
Last updated
07/08/2007
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