# GREAT HEALTH MEDICAL IN PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588464242
- **Authorized official:** AZLAN TARIQ (DO)
- **Authorized official phone:** (212) 734-6621

## Contact information

- **Practice address:** 1345 N MADISON AVE, ANDERSON, IN 46011-1215
- **Practice address phone:** (718) 470-0288
- **Mailing address:** 407 WILLOUGHBY AVE, BROOKLYN, NY 11205-4590

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/13/2025
- **Last updated:** 01/12/2026