Mohammad O Azam PA

NPI 1669626024 - Physician Assistant - 363AM0700X

NPI Details
NPI 1669626024
Gender Male
Enumeration Date 11/12/2008
Last Updated 11/12/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
10 E MERRICK RD
SUITE 207
VALLEY STREAM NY, 11580-5800, US
Phone (516) 256-2017
Fax (516) 256-2029
Business Location
10 E MERRICK RD
SUITE 207
VALLEY STREAM NY, 11580-5800, US
Phone (516) 256-2017
Fax (516) 256-2029
Toxanomy
Taxonomy Code 363AM0700X
License State New York
License Number 012399
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According to our database, Mohammad O Azam PA NPI is 1669626024, taxonomy code is 363AM0700X and license number is 012399, license state is located at New York. Mohammad O Azam PA physically located at 10 E Merrick Rd, Valley Stream NY, 11580-5800. NPI Number Mohammad O Azam PA has the Individual type.

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1669626024 NPI number is provided on an as is basis without warranty of any kind. 1669626024 is maintained by the National Plan & Provider Enumeration System. The contents of Mohammad O Azam PA are for informational purposes only.