Provider Demographics
NPI:1225101991
Name:REZA, SYED HYDER (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:HYDER
Last Name:REZA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:345 MAIN AVE
Mailing Address - Street 2:PMCC
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-1547
Mailing Address - Country:US
Mailing Address - Phone:203-849-7777
Mailing Address - Fax:203-846-4477
Practice Address - Street 1:345 MAIN AVE
Practice Address - Street 2:PMCC
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-1547
Practice Address - Country:US
Practice Address - Phone:203-849-7777
Practice Address - Fax:203-846-4477
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT030279207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTE37219Medicare UPIN