Provider Demographics
NPI:1811004393
Name:HAZARI, ARVIND M (MD)
Entity Type:Individual
Prefix:DR
First Name:ARVIND
Middle Name:M
Last Name:HAZARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41-02 31 AVE
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-3420
Mailing Address - Country:US
Mailing Address - Phone:718-777-0980
Mailing Address - Fax:718-967-2581
Practice Address - Street 1:41-02 31 AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-3420
Practice Address - Country:US
Practice Address - Phone:718-777-0980
Practice Address - Fax:718-967-2581
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY138078208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00807736Medicaid
NY00807736Medicaid
NYC05417Medicare UPIN