Individual
IBRAHIM RAZA PASHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 LAKE ST, NEWBURGH, NY 12550-5243
(845) 565-8022
(845) 565-6349
Mailing address
4107 RIDGECREST DR, WAPPINGERS FALLS, NY 12590-7540
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
288684
NY
208M00000X
Hospitalist Physician
288684
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03460982
—
NY
Enumeration date
06/22/2012
Last updated
11/09/2018
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