Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 113740 | NY |
Y | 208600000X | Surgeon | 113740 | NY |
N | 2086S0105X | Surgery of the Hand | 113740 | NY |
N | 2086S0122X | Plastic and Reconstructive Surgery | 113740 | NY |
NPI | 1316457690 |
---|---|
Provider Name | Dr. Azra Bano Rezwi |
First Address | New York, NY 10021 |
Second Address | New York, NY 10021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2017 |
Last Update Date | 02/10/2017 |