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General NPI Number Information
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NPI Number | 1457391310
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Entity Type | Individual
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Provider Name | REHAN AZIZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 08/05/2021
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Provider Practice Location Address
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Address Line | 125 PATERSON ST STE 6100
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1962
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Country | US
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Telephone | 732-235-7647
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Fax | 732-235-7767
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Provider Business Mailing Address
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Address Line | PO BOX 829642
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City | PHILADELPHIA
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State | PA
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Zip | 19182-9642
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Country | US
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Telephone | 866-470-6626
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Fax | 413-599-0470
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 043579
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 043579
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA09827200
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License Number State | NJ
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