Provider Demographics
NPI:1740375617
Name:AZIZ, NABIL A (MD)
Entity type:Individual
Prefix:DR
First Name:NABIL
Middle Name:A
Last Name:AZIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5100 W TAFT RD
Mailing Address - Street 2:STE 3R
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088
Mailing Address - Country:US
Mailing Address - Phone:315-452-2240
Mailing Address - Fax:315-452-2237
Practice Address - Street 1:5100 W TAFT RD
Practice Address - Street 2:STE 3R
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088
Practice Address - Country:US
Practice Address - Phone:315-452-2240
Practice Address - Fax:315-452-2237
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1631362084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01070415Medicaid
AA0963Medicare ID - Type Unspecified
B51298Medicare UPIN
NYCC7499Medicare PIN