Provider Demographics
NPI:1184180119
Name:BAZZI, NAIF
Entity Type:Individual
Prefix:
First Name:NAIF
Middle Name:
Last Name:BAZZI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28001 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-1561
Mailing Address - Country:US
Mailing Address - Phone:586-871-2727
Mailing Address - Fax:
Practice Address - Street 1:20434 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1416
Practice Address - Country:US
Practice Address - Phone:248-478-3922
Practice Address - Fax:248-478-3923
Is Sole Proprietor?:No
Enumeration Date:2019-02-14
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302412078183500000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist