Provider Demographics
NPI:1033283759
Name:VAZIR, AMANULLAH A (MD)
Entity Type:Individual
Prefix:
First Name:AMANULLAH
Middle Name:A
Last Name:VAZIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 MCBRIDE AVE
Mailing Address - Street 2:SUITE 201B
Mailing Address - City:WOODLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-2570
Mailing Address - Country:US
Mailing Address - Phone:973-256-0287
Mailing Address - Fax:973-256-2876
Practice Address - Street 1:999 MCBRIDE AVE
Practice Address - Street 2:SUITE 201B
Practice Address - City:WOODLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07424-2570
Practice Address - Country:US
Practice Address - Phone:973-256-0287
Practice Address - Fax:973-256-2876
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA55076207RP1001X, 207RS0012X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6187609Medicaid
NJ6187609Medicaid
F81548Medicare UPIN