Individual
DR. MIGUEL ANTONIO DE AZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2957 NORTH 5TH ST, 2ND FLOOR, PHILADELPHIA, PA 19133-2800
(484) 221-9135
(484) 221-9130
Mailing address
2030 TILGHMAN ST, LVCMHC INC, ALLENTOWN, PA 18104-4354
(484) 221-9135
(484) 221-9130
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
146D00000X
Personal Emergency Response Attendant
Primary
15822
PR
Other
Enumeration date
04/12/2006
Last updated
03/18/2008
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