Provider Demographics
NPI:1245568062
Name:AZIZIAN, YAFIT (PA)
Entity Type:Individual
Prefix:
First Name:YAFIT
Middle Name:
Last Name:AZIZIAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10 PENINSULA BLVD
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-2469
Mailing Address - Country:US
Mailing Address - Phone:516-599-4242
Mailing Address - Fax:516-599-4449
Practice Address - Street 1:2270 KIMBALL ST
Practice Address - Street 2:SUITE NUMBER 201
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5139
Practice Address - Country:US
Practice Address - Phone:718-253-4550
Practice Address - Fax:718-253-6430
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0112451363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical