Healthcare Provider Details

I. General information

NPI: 1467065466
Provider Name (Legal Business Name): ARMGHAN AZHAR AZHAR MUNIR M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date: 07/15/2021
Reactivation Date: 08/13/2021

III. Provider practice location address

1 BROOKDALE PLZ
BROOKLYN NY
11212-3139
US

IV. Provider business mailing address

17 HANOVER PL APT 26C
BROOKLYN NY
11201-7935
US

V. Phone/Fax

Practice location:
  • Phone: 718-240-5000
  • Fax:
Mailing address:
  • Phone: 332-217-9003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number333342-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: