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General NPI Number Information
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NPI Number | 1912351461
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Entity Type | Organization
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Legal Business Name | VERRAZANO MEDICAL CARE, P.C.
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Dates
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Enumeration Date | 04/21/2016
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Last Update Date | 05/10/2016
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Provider Practice Location Address
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Address Line | 1487 RICHMOND RD
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City | STATEN ISLAND
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State | NY
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Zip | 10304-2311
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Country | US
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Telephone | 718-979-3643
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Fax |
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Provider Business Mailing Address
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Address Line | 343 DONGAN HILLS AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-2206
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Country | US
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Telephone | 917-640-6282
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | RAJA ASIF MASOOD
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Credential | M.D.
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Telephone | 917-640-6282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 257739
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License Number State | NY
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