Healthcare Provider Details

I. General information

NPI: 1366122855
Provider Name (Legal Business Name): AZZ MEDCAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WALNUT LN
YARDLEY PA
19067-2000
US

IV. Provider business mailing address

1 WALNUT LN
YARDLEY PA
19067-2000
US

V. Phone/Fax

Practice location:
  • Phone: 609-890-1050
  • Fax: 609-890-0950
Mailing address:
  • Phone: 609-890-1050
  • Fax: 609-890-0950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SHAHID MEER
Title or Position: OWNER
Credential: MD
Phone: 609-943-8806