Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N005394 | NY |
NPI | 1174611164 |
---|---|
Provider Name | Dr. Mazda Alaie |
First Address | Bronx, NY 10458-1000 |
Second Address | Bronx, NY 10453-4303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 24/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U76440 | (02) | NY |