Provider Demographics
NPI:1467152330
Name:AZAD, MUHAMMAD CHANCHAL
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:CHANCHAL
Last Name:AZAD
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 1:8750 KINGSTON PL APT 1C
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4626
Mailing Address - Country:US
Mailing Address - Phone:929-636-8099
Mailing Address - Fax:
Practice Address - Street 1:MONTEFIORE MEDICAL CENTER MOSES CAMPUS 111 E 210TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-4236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program