Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | MA55076 | NJ |
Y | 207RP1001X | Pulmonary Disease | MA55076 | NJ |
N | 207RS0012X | Sleep Medicine | MA55076 | NJ |
NPI | 1033283759 |
---|---|
Provider Name | Amanullah A Vazir |
First Address | Woodland Park, NJ 07424-2570 |
Second Address | Woodland Park, NJ 07424-2570 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 02/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6187609 | (05) | NJ |
F81548 | (02) |