Healthcare Provider Details

I. General information

NPI: 1588953285
Provider Name (Legal Business Name): OSAMA TARIQ NIAZI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1955 W FRYE RD
CHANDLER AZ
85224-6282
US

IV. Provider business mailing address

3200 S ALMA SCHOOL RD STE 204
CHANDLER AZ
85248-3773
US

V. Phone/Fax

Practice location:
  • Phone: 480-728-5500
  • Fax:
Mailing address:
  • Phone: 480-728-5500
  • Fax: 480-728-5550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number007871
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number007871
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number288333
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number054774
License Number StateCT
# 5
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number288333
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: