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Individual

DR. REHAN AZIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
125 PATERSON ST STE 6100, NEW BRUNSWICK, NJ 08901-1962
(732) 235-7647
(732) 235-7767
Mailing address
PO BOX 829642, PHILADELPHIA, PA 19182-9642
(866) 470-6626
(413) 599-0470

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
043579
CT
2084P0800X
Psychiatry Physician
Primary
25MA09827200
NJ
2084P0805X
Geriatric Psychiatry Physician
043579
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001435791
CT
05
001435793
CT
01
06-1483276
GROUP TAX ID.
CT
01
260004885
MEDICARE PTAN
CT
01
35960
CONTROLLED SUBSTANCE REG.
CT
01
C02270
GROUP MEDICARE ID.
CT
Enumeration date
06/08/2006
Last updated
08/05/2021
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