Provider Demographics
NPI:1255908604
Name:RAZAQ, ZAREEN
Entity type:Individual
Prefix:
First Name:ZAREEN
Middle Name:
Last Name:RAZAQ
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 1:126 MEADOW ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-6600
Mailing Address - Country:US
Mailing Address - Phone:347-303-2277
Mailing Address - Fax:
Practice Address - Street 1:NORTH MISSISSIPPI HEALTH SERVICES
Practice Address - Street 2:830 SOUTH GLOSTER STREET
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801
Practice Address - Country:US
Practice Address - Phone:662-377-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-04
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS390200000X
MST-4356207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program