Provider Demographics
NPI:1942208566
Name:HAZARI, SAROJ ARVIND (MD)
Entity Type:Individual
Prefix:
First Name:SAROJ
Middle Name:ARVIND
Last Name:HAZARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 ALBOURNE AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-3033
Mailing Address - Country:US
Mailing Address - Phone:718-967-2879
Mailing Address - Fax:718-967-2581
Practice Address - Street 1:248 ALBOURNE AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-3033
Practice Address - Country:US
Practice Address - Phone:718-967-2879
Practice Address - Fax:718-967-2581
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142907-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01173977Medicaid
NY50F562Medicare ID - Type Unspecified
NY01173977Medicaid