Provider Demographics
NPI:1407019730
Name:AZAR, ANTOINE (MD)
Entity Type:Individual
Prefix:
First Name:ANTOINE
Middle Name:
Last Name:AZAR
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 1:1304 BUCKLEY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-4317
Mailing Address - Country:US
Mailing Address - Phone:315-478-3311
Mailing Address - Fax:
Practice Address - Street 1:1304 BUCKLEY ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-4317
Practice Address - Country:US
Practice Address - Phone:315-478-3311
Practice Address - Fax:315-476-5211
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY270249207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology