MEDICARE: DR. HAMZA PERVAIZ MD

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	207R00000X	Internal Medicine Physician	340829	NY

General Provider Information

NPI Number	:	1366171845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAMZA PERVAIZ MD

Provider Business Mailing Address
First Line	:	10 HARBOR CT E
Second Line	:
City	:	ROSLYN
State	:	NY
Zip	:	11576-2435
Country	:	US
Telephone Number	:	929-484-1236
Fax Number	:

Provider Business Practice Location Address
First Line	:	11616 LIBERTY AVE
Second Line	:
City	:	SOUTH RICHMOND HILL
State	:	NY
Zip	:	11419-1941
Country	:	US
Telephone Number	:	718-641-1117
Fax Number	:	718-756-1390

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

Provider Enumeration Date	:	06/09/2022
Last Update Date	:	12/01/2025

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