Provider Demographics
NPI:1831471192
Name:NIYAZOV, DAVID (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:NIYAZOV
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-5001
Mailing Address - Country:US
Mailing Address - Phone:917-962-4444
Mailing Address - Fax:917-962-4451
Practice Address - Street 1:709 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-5001
Practice Address - Country:US
Practice Address - Phone:917-962-4444
Practice Address - Fax:917-962-4451
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056136183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist