Provider Demographics
NPI:1558716464
Name:SYED H REZA, MD P.C.
Entity Type:Organization
Organization Name:SYED H REZA, MD P.C.
Other - Org Name:PRIMARY MEDICAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:HYDER
Authorized Official - Last Name:REZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-846-8440
Mailing Address - Street 1:346 MAIN AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-1592
Mailing Address - Country:US
Mailing Address - Phone:203-846-8440
Mailing Address - Fax:203-295-8498
Practice Address - Street 1:346 MAIN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-1592
Practice Address - Country:US
Practice Address - Phone:203-846-8440
Practice Address - Fax:203-295-8498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT030279261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care