Healthcare Provider Details
I. General information
NPI: 1790289643
Provider Name (Legal Business Name): HAMZA MURTAZA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/23/2018
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1182 TROY SCHENECTADY RD STE 100
LATHAM NY
12110-1000
US
IV. Provider business mailing address
PO BOX 14890
ALBANY NY
12212-4890
US
V. Phone/Fax
- Phone: 518-269-4690
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 308459 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0114X |
| Taxonomy | Adult Reconstructive Orthopaedic Surgery Physician |
| License Number | 308459 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: