Provider Demographics
NPI:1407148851
Name:AZAR A KORBEY MD PLLC
Entity Type:Organization
Organization Name:AZAR A KORBEY MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AZAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:KORBEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-893-7905
Mailing Address - Street 1:22 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-5900
Mailing Address - Country:US
Mailing Address - Phone:603-893-7905
Mailing Address - Fax:
Practice Address - Street 1:22 MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-5900
Practice Address - Country:US
Practice Address - Phone:603-893-7905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7069332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE6093Medicare PIN