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NPI Code Detail

MEDICARE: DR. BASEM NADY AZAB M.D.

MEDICARE: DR. BASEM NADY AZAB M.D.
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
1208600000XSurgery Physician274207NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457506867
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BASEM NADY AZAB M.D.
Provider Business Mailing Address
First Line : 722 W WATER ST
Second Line :
City : ELMIRA
State : NY
Zip : 14905-2435
Country : US
Telephone Number : 607-271-2050
Fax Number :
Provider Business Practice Location Address
First Line : 1138 BROADWAY ST
Second Line :
City : ELMIRA
State : NY
Zip : 14904-2502
Country : US
Telephone Number : 607-734-7982
Fax Number : 607-734-1953
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2008
Last Update Date : 07/20/2015

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