Healthcare Provider Details

I. General information

NPI: 1720918006
Provider Name (Legal Business Name): AFRIN AZAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1086 FRANKLIN ST
JOHNSTOWN PA
15905-4305
US

IV. Provider business mailing address

1086 FRANKLIN ST
JOHNSTOWN PA
15905-4305
US

V. Phone/Fax

Practice location:
  • Phone: 814-534-9106
  • Fax: 814-534-5599
Mailing address:
  • Phone: 814-534-9106
  • Fax: 814-534-5599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT237165
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: