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Individual

DR. ABUL KALAM AZAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD, MSC, PHD

Contact information

Practice address
1635 POPLAR ST, BRONX, NY 10461-2600
(718) 405-8109
Mailing address
1641 METROPOLITAN AVE APT 3A, BRONX, NY 10462-6263
(713) 815-1105

Taxonomy

Speciality
Code
Description
License number
State
207SC0300X
Clinical Cytogenetics Physician
AZADA1
NY
207SG0203X
Clinical Molecular Genetics Physician
AZADA1
NY
207SG0205X
Ph.D. Medical Genetics Physician
Primary
AZADA1
NY
207SM0001X
Molecular Genetic Pathology (Medical Genetics) Physician
AZADA1
NY
247ZC0005X
Clinical Laboratory Director (Non-physician)
AZADA1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NA
NA
Enumeration date
09/02/2020
Last updated
05/24/2021
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