Organization
HOLYSPIRIT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AGHA M RAZA M.D. (PHYSICIAN)
(516) 270-6834
Entity
Organization
Contact information
Practice address
10 E MERRICK RD, SUITE 205, VALLEY STREAM, NY 11580-5800
(516) 270-6834
Mailing address
117 WALDORF AVE, ELMONT, NY 11003-1522
(516) 270-3852
(516) 887-1235
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
239302
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1790851939
INDIVIDUAL NPI
NY
Enumeration date
06/07/2007
Last updated
12/13/2010
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