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General NPI Number Information
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NPI Number | 1518331099
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Entity Type | Individual
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Provider Name | AZUMAH LAAR
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Gender | Male
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Dates
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Enumeration Date | 11/20/2015
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Last Update Date | 01/04/2025
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Provider Practice Location Address
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Address Line | 2833 BRIGGS AVE APT 1D
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City | BRONX
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State | NY
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Zip | 10458-3328
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Country | US
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Telephone | 347-741-5178
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Fax |
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Provider Business Mailing Address
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Address Line | 1012 SUMMER LN
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City | MCKINNEY
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State | TX
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Zip | 75071-1228
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Country | US
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Telephone | 469-307-6294
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1144227
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 305821
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 706746
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License Number State | NY
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