Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 186230 | NY |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 186230 | NY |
NPI | 1033143680 |
---|---|
Provider Name | Azfar Shabbir |
First Address | Elmhurst, NY 11373-1329 |
Second Address | Elmhurst, NY 11373-1329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 23/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01502845 | (05) | NY |
G02012 | (02) | NY |