Healthcare Provider Details

I. General information

NPI: 1346294311
Provider Name (Legal Business Name): ANTHONY P. AZAR, M.D. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 10/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 LAFAYETTE ST FL 6
NEW YORK NY
10013-4153
US

IV. Provider business mailing address

101 LAFAYETTE ST FL 6
NEW YORK NY
10013-4153
US

V. Phone/Fax

Practice location:
  • Phone: 212-274-1705
  • Fax: 212-274-0776
Mailing address:
  • Phone: 212-274-1705
  • Fax: 212-274-0776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number182329
License Number StateNY

VIII. Authorized Official

Name: DR. ANTHONY P. AZAR
Title or Position: ADMINISTRATOR
Credential: M.D.
Phone: 212-274-1705