Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 146813 | NY |
NPI | 1104809656 |
---|---|
Provider Name | Dr. Azra Raza |
First Address | New York, NY 10032-3725 |
Second Address | New York, NY 10032-3729 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 23/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2088797 | (05) | MA |
E76026 | (02) | MA |