Individual
MR. MOHAMMED REEZA FAROZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4211 BELL BLVD, BAYSIDE, NY 11361-2863
(212) 385-3700
Mailing address
4211 BELL BLVD, BAYSIDE, NY 11361-2863
(212) 385-3700
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
026595
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
03/20/2021
Last updated
05/16/2022
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