Individual
AZLINE EXIME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1250 WATERS PL, BRONX, NY 10461-2720
(516) 904-8420
Mailing address
73 DIVISION ST, WESTBURY, NY 11590-4062
(516) 904-8420
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/21/2024
Last updated
09/11/2025
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