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Individual

AZHAR SUPARIWALA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
280 E MAIN ST, BAY SHORE, NY 11706-8403
(631) 591-7400
(631) 591-7401
Mailing address
10 AMSTERDAM AVE, APT 904, NEW YORK, NY 10023-7464
(646) 434-9257

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
270119
NY
282N00000X
General Acute Care Hospital

Other

Enumeration date
11/08/2010
Last updated
06/22/2014
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