Provider Demographics
NPI:1376863266
Name:IZZY, SAEF (MD)
Entity Type:Individual
Prefix:
First Name:SAEF
Middle Name:
Last Name:IZZY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SAEF
Other - Middle Name:
Other - Last Name:AHMAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:45 FRANCIS ST # BB-330
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6105
Mailing Address - Country:US
Mailing Address - Phone:617-732-7432
Mailing Address - Fax:
Practice Address - Street 1:45 FRANCIS ST # BB-330
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6105
Practice Address - Country:US
Practice Address - Phone:617-732-7432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ614422084N0400X
MA2571132084N0400X
FLTPME3092084N0400X
GA862452084N0400X
KY544242084N0400X
NC2020-031062084N0400X
VA01012698422084N0400X
IN01084470A2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology