Provider Demographics
NPI:1932182649
Name:AZURIN, JAMES CRAIG (MD MS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CRAIG
Last Name:AZURIN
Suffix:
Gender:M
Credentials:MD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2101 LAC DEVILLE BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-5659
Mailing Address - Country:US
Mailing Address - Phone:585-546-3265
Mailing Address - Fax:585-232-5158
Practice Address - Street 1:2101 LAC DEVILLE BOULEVARD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-5659
Practice Address - Country:US
Practice Address - Phone:585-546-3265
Practice Address - Fax:585-232-5158
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231421-12084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02785486Medicaid
NY02785486Medicaid