Provider Demographics
NPI:1467592709
Name:AZULAY, NAOMI (PT)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:AZULAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 YORK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-5970
Mailing Address - Country:US
Mailing Address - Phone:212-613-0990
Mailing Address - Fax:212-628-7059
Practice Address - Street 1:1550 YORK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-5970
Practice Address - Country:US
Practice Address - Phone:212-613-0990
Practice Address - Fax:212-628-7059
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006739225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ00171OtherEMPIRE BLUE CROSS
NYQ00171Medicare ID - Type UnspecifiedNY MEDICARE PROVIDER #