Provider Demographics
NPI:1780924142
Name:AFZAL, UZMA (PA)
Entity type:Individual
Prefix:MISS
First Name:UZMA
Middle Name:
Last Name:AFZAL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2066 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3960
Mailing Address - Country:US
Mailing Address - Phone:718-982-9001
Mailing Address - Fax:718-982-9008
Practice Address - Street 1:2066 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3960
Practice Address - Country:US
Practice Address - Phone:718-982-9001
Practice Address - Fax:718-982-9008
Is Sole Proprietor?:No
Enumeration Date:2013-02-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016347-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant