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General NPI Number Information
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NPI Number | 1083600670
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Entity Type | Individual
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Provider Name | QAZI QAISAR AFZAL MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 11/28/2022
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Provider Practice Location Address
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Address Line | 285 SILLS RD BUILDING 7, SUITE B
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City | EAST PATCHOGUE
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State | NY
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Zip | 11772-4869
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Country | US
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Telephone | 631-654-4577
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Fax | 631-654-3391
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Provider Business Mailing Address
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Address Line | 285 SILLS RD BUILDING 7, SUITE B
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City | EAST PATCHOGUE
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State | NY
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Zip | 11772-4869
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Country | US
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Telephone | 631-654-4577
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Fax | 631-654-3391
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 1771071
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License Number State | NY
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