Healthcare Provider Details

I. General information

NPI: 1255257168
Provider Name (Legal Business Name): MUNIR AZANKI MARQUES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36-11 21ST ST.
LONG ISLAND CITY NY
11106
US

IV. Provider business mailing address

36-11 21ST ST.
LONG ISLAND CITY NY
11106
US

V. Phone/Fax

Practice location:
  • Phone: 718-482-7772
  • Fax: 718-482-9648
Mailing address:
  • Phone: 718-482-7772
  • Fax: 718-482-9648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: