Healthcare Provider Details

I. General information

NPI: 1124394101
Provider Name (Legal Business Name): HANA AZIZI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANA AZIZI M.D.

II. Dates (important events)

Enumeration Date: 03/23/2012
Last Update Date: 12/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 FORT WASHINGTON AVE HARKNESS PAVILION 1ST FLOOR/ SUITE 199
NEW YORK NY
10032
US

IV. Provider business mailing address

180 FORT WASHINGTON AVE HARKNESS PAVILION 1ST FLOOR/ SUITE 199
NEW YORK NY
10032
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-3535
  • Fax: 212-342-1470
Mailing address:
  • Phone: 212-305-3535
  • Fax: 212-342-1470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number282470
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number282470
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: