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Individual

FAZLE AZEEM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5015 BEACH CHANNEL DR, FAR ROCKAWAY, NY 11691-1110
(718) 734-2000
Mailing address
40 DORA ST, STATEN ISLAND, NY 10314-2107
(917) 202-8684

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
109585-01
NY

Other

Enumeration date
05/27/2021
Last updated
11/03/2024
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