Provider Demographics
NPI:1740738624
Name:KNOX, AZIZI
Entity Type:Individual
Prefix:
First Name:AZIZI
Middle Name:
Last Name:KNOX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 MULFORD AVE
Mailing Address - Street 2:17B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-4317
Mailing Address - Country:US
Mailing Address - Phone:917-639-6627
Mailing Address - Fax:
Practice Address - Street 1:1740 MULFORD AVE
Practice Address - Street 2:17B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-4317
Practice Address - Country:US
Practice Address - Phone:917-639-6627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY719298163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse