Provider Demographics
NPI:1902838816
Name:ANAND, M.D., P.C., AZAD K (MD)
Entity Type:Individual
Prefix:
First Name:AZAD
Middle Name:K
Last Name:ANAND, M.D., P.C.
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:PO BOX 63
Mailing Address - Street 2:LONG ISLAND DIAGNOSTIC IMAGING
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-0063
Mailing Address - Country:US
Mailing Address - Phone:631-689-7300
Mailing Address - Fax:631-689-7321
Practice Address - Street 1:23 TECHNOLOGY DR
Practice Address - Street 2:LONG ISLAND DIAGNSOTIC IMAGING
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-4075
Practice Address - Country:US
Practice Address - Phone:631-689-7300
Practice Address - Fax:631-689-7321
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1380792085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY112983328OtherTAX ID
NY1194851931OtherSITE NPI NUMBER
NY1548396203OtherSITE NPI NUMBER
NY00571857Medicaid
NY1114189735OtherGROUP NPI NUMBER
NY1689700403OtherSITE NPI NUMBER
NY112797720OtherTAX ID
NY1982730784OtherSITE NPI NUMBER
NY113119124OtherTAX ID
NY112797720OtherTAX ID
NY113119124OtherTAX ID