Provider Demographics
NPI:1932216512
Name:AZEEZ, ABDUL C K (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDUL
Middle Name:C K
Last Name:AZEEZ
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 1:5 CANTERBURY COURT
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1820
Mailing Address - Country:US
Mailing Address - Phone:914-423-8000
Mailing Address - Fax:
Practice Address - Street 1:970 N BROADWAY
Practice Address - Street 2:308B
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701
Practice Address - Country:US
Practice Address - Phone:914-423-8000
Practice Address - Fax:914-423-4833
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155093207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00D031OtherBCBS
0H4778OtherACS HEALTHNET
0003993OtherGHI
NY00787242Medicaid
WP611OtherOXFORD
NY00787242Medicaid
NY00D031Medicare PIN