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General NPI Number Information
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NPI Number | 1598861031
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Entity Type | Individual
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Provider Name | SERGEI E RAZOV MD
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Gender | Male
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 150 55TH ST
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City | BROOKLYN
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State | NY
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Zip | 11220-2508
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Country | US
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Telephone | 718-630-6324
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Fax |
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Provider Business Mailing Address
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Address Line | 71 ANDREW ST
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City | NEWTON
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State | MA
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Zip | 02461-2144
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Country | US
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Telephone | 617-332-5941
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Fax | 781-744-8215
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 209049
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License Number State | MA
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