Healthcare Provider Details

I. General information

NPI: 1255908604
Provider Name (Legal Business Name): ZAREEN RAZAQ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2021
Last Update Date: 10/18/2021
Certification Date: 10/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NORTH MISSISSIPPI HEALTH SERVICES 830 SOUTH GLOSTER STREET
TUPELO MS
38801
US

IV. Provider business mailing address

126 MEADOW ST
GARDEN CITY NY
11530-6600
US

V. Phone/Fax

Practice location:
  • Phone: 662-377-3000
  • Fax:
Mailing address:
  • Phone: 347-303-2277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberT-4356
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: