MEDICARE: DR. AYAZ RASOOL 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
1	208800000X	Urology Physician	152821	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1467561043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AYAZ RASOOL MD

Provider Business Mailing Address
First Line	:	7603 113TH ST
Second Line	:	STE M6
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-6585
Country	:	US
Telephone Number	:	718-268-7262
Fax Number	:	718-263-6418

Provider Business Practice Location Address
First Line	:	7603 113TH ST
Second Line	:	SUITE M6
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-6585
Country	:	US
Telephone Number	:	718-268-7262
Fax Number	:	718-263-6418

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	04/01/2014

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