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General NPI Number Information
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NPI Number | 1467019455
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Entity Type | Individual
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Provider Name | ALI AZZAWI MD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2019
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 5645 MAIN ST
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City | FLUSHING
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State | NY
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Zip | 11355-5045
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Country | US
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Telephone | 718-670-1507
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Fax |
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Provider Business Mailing Address
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Address Line | 4540 CENTER BLVD APT 1910
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City | LONG ISLAND CITY
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State | NY
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Zip | 11109-5808
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Country | US
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Telephone | 718-670-1507
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35.146387
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101276694
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License Number State | VA
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