Provider Demographics
NPI:1609196112
Name:SHWANI, HAZIM GAZY (MS NUTRITIONIST)
Entity Type:Individual
Prefix:
First Name:HAZIM
Middle Name:GAZY
Last Name:SHWANI
Suffix:
Gender:M
Credentials:MS NUTRITIONIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 IDEAL ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14206-1121
Mailing Address - Country:US
Mailing Address - Phone:716-228-7218
Mailing Address - Fax:
Practice Address - Street 1:250 IDEAL ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14206-1121
Practice Address - Country:US
Practice Address - Phone:716-228-7218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist