MEDICARE: MICHEL AZIZ

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	183500000X	Pharmacist	RP451938	PA

General Provider Information

NPI Number	:	1780173401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHEL AZIZ

Provider Business Mailing Address
First Line	:	134 S 12TH ST
Second Line	:
City	:	ALLENTOWN
State	:	PA
Zip	:	18102-4743
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2023 LYCOMING CREEK RD
Second Line	:
City	:	WILLIAMSPORT
State	:	PA
Zip	:	17701-1206
Country	:	US
Telephone Number	:	570-327-9920
Fax Number	:

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

Provider Enumeration Date	:	05/08/2018
Last Update Date	:	05/08/2018

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Directions to “ MICHEL AZIZ ” Practice Location

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