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General NPI Number Information
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NPI Number | 1558716464
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Entity Type | Organization
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Legal Business Name | SYED H REZA, MD P.C.
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Dates
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Enumeration Date | 04/28/2016
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Last Update Date | 04/28/2016
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Provider Practice Location Address
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Address Line | 346 MAIN AVE SUITE B
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City | NORWALK
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State | CT
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Zip | 06851-1592
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Country | US
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Telephone | 203-846-8440
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Fax | 203-295-8498
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Provider Business Mailing Address
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Address Line | 346 MAIN AVE SUITE B
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City | NORWALK
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State | CT
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Zip | 06851-1592
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Country | US
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Telephone | 203-846-8440
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Fax | 203-295-8498
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SYED HYDER REZA
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Credential | MD
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Telephone | 203-846-8440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 030279
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License Number State | CT
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