Provider Demographics
NPI:1275067522
Name:NIAZI, TARIQ KHAN (MD)
Entity Type:Individual
Prefix:
First Name:TARIQ
Middle Name:KHAN
Last Name:NIAZI
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 1:2235 OVERLOOK RD
Mailing Address - Street 2:APT 204
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-2347
Mailing Address - Country:US
Mailing Address - Phone:630-999-0963
Mailing Address - Fax:
Practice Address - Street 1:2235 OVERLOOK RD
Practice Address - Street 2:APT 204
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-2347
Practice Address - Country:US
Practice Address - Phone:630-999-0963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-13
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036163240208VP0014X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine