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NPI Code Detail

MEDICARE: MARY Z AWAD MD PC

MEDICARE: MARY Z AWAD MD PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician262348NY

General Provider Information

NPI Number : 1033478995
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARY Z AWAD MD PC
Provider Business Mailing Address
First Line : 276 MERRYMOUNT ST
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-4849
Country : US
Telephone Number : 917-771-4704
Fax Number :
Provider Business Practice Location Address
First Line : 1435 86TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11228-3435
Country : US
Telephone Number : 718-238-4441
Fax Number :
Authorized Official
Title or Position : MEDICAL DOCTOR/CEO
Name : MARY Z AWAD
Credential : M.D.
Telephone Number : 917-771-4704
Provider Enumeration Date : 05/14/2012
Last Update Date : 05/14/2012

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