Provider Demographics
NPI:1831531011
Name:FARZANA H AZIZ MD PC
Entity type:Organization
Organization Name:FARZANA H AZIZ MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARZANA
Authorized Official - Middle Name:H
Authorized Official - Last Name:AZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-605-0688
Mailing Address - Street 1:791 N CORONA AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-1545
Mailing Address - Country:US
Mailing Address - Phone:516-605-0688
Mailing Address - Fax:516-605-0688
Practice Address - Street 1:77 N BROADWAY
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-2946
Practice Address - Country:US
Practice Address - Phone:516-605-0688
Practice Address - Fax:516-605-0687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty