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NPI 1235081472

NPI 1235081472 : JIANA AZAR PTA : SYRACUSE, NY

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General NPI Number Information
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    NPI Number           |    1235081472
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    Entity Type          |    Individual 
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    Provider Name        |    JIANA AZAR PTA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/11/2026
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    Last Update Date     |    02/11/2026
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Provider Practice Location Address
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    Address Line         |    600 S WILBUR AVE 
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    City                 |    SYRACUSE
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    State                |    NY
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    Zip                  |    13204-2730
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    Country              |    US
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    Telephone            |    315-476-7441
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    Fax                  |    315-476-7446
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Provider Business Mailing Address
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    Address Line         |    600 S WILBUR AVE 
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    City                 |    SYRACUSE
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    State                |    NY
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    Zip                  |    13204-2730
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    Country              |    US
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    Telephone            |    315-476-7441
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    Fax                  |    315-476-7446
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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        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    013345
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    License Number State |    NY
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