MEDICARE: DR. PARVIN AZIZI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician	D84819	MD
2	208000000X	Pediatrics Physician	A142709	CA
3	2084N0400X	Neurology Physician	MD2013-0787	NM
4	2084N0400X	Neurology Physician	A142709	CA
5	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician	25MA11010000	NJ

General Provider Information

NPI Number	:	1215192083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PARVIN AZIZI M.D.

Provider Business Mailing Address
First Line	:	132 BRIDGE BLVD
Second Line	:
City	:	MOUNT HOLLY
State	:	NJ
Zip	:	08060-4444
Country	:	US
Telephone Number	:	832-866-7681
Fax Number	:

Provider Business Practice Location Address
First Line	:	NEURABILITIES
Second Line	:	2050 VOORHEES TOWN CENTER
City	:	VORHEES TOWNSHIP
State	:	NJ
Zip	:	08043
Country	:	US
Telephone Number	:	856-346-0005
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2008
Last Update Date	:	12/02/2024

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