Provider Demographics
NPI:1720015506
Name:AZIZ, FARZANA H (MD)
Entity Type:Individual
Prefix:
First Name:FARZANA
Middle Name:H
Last Name:AZIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 MEACHAM AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-3221
Mailing Address - Country:US
Mailing Address - Phone:516-599-2383
Mailing Address - Fax:516-599-2382
Practice Address - Street 1:374 MEACHAM AVE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-3221
Practice Address - Country:US
Practice Address - Phone:516-599-2383
Practice Address - Fax:516-599-2382
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212238207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01810099Medicaid