Provider Demographics
NPI:1598854150
Name:NAUZO, YAHAYA (DPM)
Entity Type:Individual
Prefix:DR
First Name:YAHAYA
Middle Name:
Last Name:NAUZO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 DECATUR ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-1804
Mailing Address - Country:US
Mailing Address - Phone:718-613-1353
Mailing Address - Fax:718-613-1354
Practice Address - Street 1:341 DECATUR ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-1804
Practice Address - Country:US
Practice Address - Phone:718-613-1353
Practice Address - Fax:718-613-1354
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004901-1213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01340954Medicaid
NY01340954Medicaid
NYP52361Medicare ID - Type UnspecifiedPROVIDER ID