Provider Demographics
NPI:1437481033
Name:AZMAT, JAVED
Entity Type:Individual
Prefix:
First Name:JAVED
Middle Name:
Last Name:AZMAT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2860 STEINWAY ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-3332
Mailing Address - Country:US
Mailing Address - Phone:718-278-1402
Mailing Address - Fax:718-278-2344
Practice Address - Street 1:2860 STEINWAY ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-3332
Practice Address - Country:US
Practice Address - Phone:718-278-1402
Practice Address - Fax:718-278-2344
Is Sole Proprietor?:No
Enumeration Date:2010-02-06
Last Update Date:2010-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI029428-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist