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Individual

ABUL KALAM AZAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
256 BEACH 20TH ST, FAR ROCKAWAY, NY 11691-3618
(718) 337-0533
Mailing address
184 ALDEN RD, WOODMERE, NY 11598-1810
(718) 337-0533

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
176899
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01180661
NY
Enumeration date
08/15/2006
Last updated
07/08/2007
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