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General NPI Number Information
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NPI Number | 1780839977
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Entity Type | Organization
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Legal Business Name | A.AZIZ RICHI, MD, LLC
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Dates
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Enumeration Date | 12/01/2008
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Last Update Date | 12/01/2008
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Provider Practice Location Address
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Address Line | 1389 W MAIN ST SUITE 322
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City | WATERBURY
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State | CT
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Zip | 06708-3104
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Country | US
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Telephone | 203-753-0877
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Fax | 203-759-1537
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Provider Business Mailing Address
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Address Line | 1389 W MAIN ST SUITE 322
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City | WATERBURY
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State | CT
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Zip | 06708-3104
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Country | US
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Telephone | 203-753-0877
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Fax | 203-759-1537
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Authorized Official
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Title or Position | PHYSICIAN / OWNER
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Name | DR. A.AZIZ RICHI
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Credential | MD
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Telephone | 203-753-0877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 020067
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License Number State | CT
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