Provider Demographics
NPI:1053631036
Name:RAZIUDDIN, NATASHA HASAN (RPA-C)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:HASAN
Last Name:RAZIUDDIN
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 DEER RIDGE DR
Mailing Address - Street 2:APARTMENT 309
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-2558
Mailing Address - Country:US
Mailing Address - Phone:201-317-6061
Mailing Address - Fax:
Practice Address - Street 1:100 E 77TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1850
Practice Address - Country:US
Practice Address - Phone:212-434-2000
Practice Address - Fax:212-434-2082
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013958-1363AM0700X
MDC0004752363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical