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NPI Code Detail

MEDICARE: DR. JUSTIN M AZAR MD

MEDICARE:  DR. JUSTIN M AZAR  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
12080P0203XPediatric Critical Care Medicine PhysicianMD458886PA
2208000000XPediatrics PhysicianMD042195DC
3208000000XPediatrics PhysicianMD458886PA

General Provider Information

NPI Number : 1558655688
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUSTIN M AZAR MD
Provider Business Mailing Address
First Line : 100 N ACADEMY AVE
Second Line :
City : DANVILLE
State : PA
Zip : 17822-4903
Country : US
Telephone Number : 570-271-6144
Fax Number : 570-271-6578
Provider Business Practice Location Address
First Line : 100 N ACADEMY AVE
Second Line :
City : DANVILLE
State : PA
Zip : 17822-1334
Country : US
Telephone Number : 570-271-7910
Fax Number : 570-271-6002
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2011
Last Update Date : 11/15/2024

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Directions to “ DR. JUSTIN M AZAR MD” Practice Location

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