Healthcare Provider Details

I. General information

NPI: 1780599951
Provider Name (Legal Business Name): EL AZOURY MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 CUMBERLAND HEAD RD
PLATTSBURGH NY
12901-6808
US

IV. Provider business mailing address

501 MINER FARM RD
CHAZY NY
12921-2206
US

V. Phone/Fax

Practice location:
  • Phone: 203-691-0542
  • Fax:
Mailing address:
  • Phone: 203-691-0542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: PAUL GERGI EL AZOURY
Title or Position: OWNER
Credential:
Phone: 203-691-0542