Provider Demographics
NPI:1134654387
Name:AZHAR, MUHAMMAD (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:
Last Name:AZHAR
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 1:9610 57TH AVE
Mailing Address - Street 2:APT 8 K
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-3436
Mailing Address - Country:US
Mailing Address - Phone:347-951-4328
Mailing Address - Fax:
Practice Address - Street 1:ONE BROOKDALE PLAZA
Practice Address - Street 2:BROOKDALE MEDICAL CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212
Practice Address - Country:US
Practice Address - Phone:347-951-4328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY320994207RN0300X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology