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Individual

AZUKA S ITABOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
624 MCCLELLAN ST, SUITE 101, SCHENECTADY, NY 12304-1020
(518) 382-2260
(518) 347-5007
Mailing address
624 MCCLELLAN ST, SUITE 101, SCHENECTADY, NY 12304-1020
(518) 382-2260
(518) 347-5007

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
280483
NY
207V00000X
Obstetrics & Gynecology Physician
280483
NY

Other

Enumeration date
09/04/2012
Last updated
06/30/2015
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