Individual
KAZI M ISLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
23 E LA CROSSE AVE, LANSDOWNE, PA 19050-2002
(610) 394-2130
(610) 394-2177
Mailing address
1025 CAPIE POLK DRIVE, SPRINGFIELD, PA 19064
(610) 544-1512
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD051940L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1466911
—
PA
Enumeration date
10/02/2006
Last updated
06/14/2019
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