Provider Demographics
NPI:1407629645
Name:AZIZ A SOOMRO M.D P.C.
Entity Type:Organization
Organization Name:AZIZ A SOOMRO M.D P.C.
Other - Org Name:AZIZ A. SOOMRO M.D P.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AZIZ
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:SOOMRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-560-6497
Mailing Address - Street 1:187 DOT CT E
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-5920
Mailing Address - Country:US
Mailing Address - Phone:929-468-6584
Mailing Address - Fax:
Practice Address - Street 1:187 DOT CT E
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-5920
Practice Address - Country:US
Practice Address - Phone:929-560-6497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-31
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty