Organization
AGING WELL RN NP FAMILY HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AZZA A EZZAT NP (PRESIDENT)
(717) 716-7107
Entity
Organization
Contact information
Practice address
774 MANOR RD, STATEN ISLAND, NY 10314-7038
(718) 496-2542
Mailing address
796 RATHBUN AVE, STATEN ISLAND, NY 10309-2409
(717) 716-7107
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NY
Other
Enumeration date
05/07/2009
Last updated
04/24/2026
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