Provider Demographics
NPI:1861013039
Name:AZIZ, KASHIF
Entity Type:Individual
Prefix:
First Name:KASHIF
Middle Name:
Last Name:AZIZ
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 1:65 JAMES STREET
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820
Mailing Address - Country:US
Mailing Address - Phone:732-321-7010
Mailing Address - Fax:732-632-1584
Practice Address - Street 1:225 WILLIAMSON STREET
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202
Practice Address - Country:US
Practice Address - Phone:908-994-5420
Practice Address - Fax:908-351-7930
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2022-01-13
Deactivation Date:2022-01-10
Deactivation Code:
Reactivation Date:2022-01-13
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program