Provider Demographics
NPI:1457307506
Name:AZAR, ANTHONY P (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:P
Last Name:AZAR
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 1:101 LAFAYETTE ST FL 6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4153
Mailing Address - Country:US
Mailing Address - Phone:212-274-1705
Mailing Address - Fax:212-274-0776
Practice Address - Street 1:101 LAFAYETTE ST FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4153
Practice Address - Country:US
Practice Address - Phone:212-274-1705
Practice Address - Fax:212-274-0776
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182329173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY98F682Medicare ID - Type Unspecified
NYE97927Medicare UPIN