MEDICARE: AZAD K. ANAND, 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
1	2085R0202X	Diagnostic Radiology Physician	51020547	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51020547	OTHER	NY	DOH CERTIFICATE OF REGIST
2	1902838816	OTHER	NY	INDIVIDUAL NPI
3	120964	OTHER	NY	FDA CERTIFICATION

General Provider Information

NPI Number	:	1689700403
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AZAD K. ANAND, MD, PC

Provider Business Mailing Address
First Line	:	100 LAFAYETTE DR
Second Line	:
City	:	SYOSSET
State	:	NY
Zip	:	11791-3934
Country	:	US
Telephone Number	:	516-364-4600
Fax Number	:	516-364-4646

Provider Business Practice Location Address
First Line	:	23 TECHNOLOGY DR
Second Line	:
City	:	EAST SETAUKET
State	:	NY
Zip	:	11733-4075
Country	:	US
Telephone Number	:	631-689-7300
Fax Number	:	631-689-7321

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. LORIE A DAVIDSON
Credential	:
Telephone Number	:	516-364-4600

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	03/13/2008

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