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NPI Code Detail

MEDICARE: BUSHRA WAZED MD

MEDICARE: BUSHRA WAZED MD
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 Physician295486-1NY

General Provider Information

NPI Number : 1295122711
Entity Type Code : Individual
Provider Name (Legal Business Name) : BUSHRA WAZED MD
Provider Business Mailing Address
First Line : 79 MIDDLEVILLE RD BLDG 200A332
Second Line :
City : NORTHPORT
State : NY
Zip : 11768-2296
Country : US
Telephone Number : 631-261-4400
Fax Number :
Provider Business Practice Location Address
First Line : 79 MIDDLEVILLE RD BLDG 200A332
Second Line :
City : NORTHPORT
State : NY
Zip : 11768-2296
Country : US
Telephone Number : 631-261-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2015
Last Update Date : 01/21/2024

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Directions to “ BUSHRA WAZED MD” Practice Location

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