Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist |
NPI | 1629393608 |
---|---|
Provider Name | Dr. Zahra Fayzi |
First Address | Clarence Center, NY 14032-9400 |
Second Address | Clarence Center, NY 14032-9400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2010 |
Last Update Date | 01/04/2010 |