=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588049894
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEEZA KAZI PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2015
-----------------------------------------------------
Last Update Date | 06/14/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 88 SILVA LN # LANE4
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02842-7634
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-344-1099
-----------------------------------------------------
Fax | 401-619-5215
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23 S EAGLE NEST DR
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02865-3732
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-569-7463
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RPH05462
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------