Provider Demographics
NPI:1902657182
Name:AZMY, SHADY (MD)
Entity Type:Individual
Prefix:
First Name:SHADY
Middle Name:
Last Name:AZMY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 EAST 77TH STREET
Mailing Address - Street 2:BLACK HALL, 13TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075
Mailing Address - Country:US
Mailing Address - Phone:212-434-3420
Mailing Address - Fax:
Practice Address - Street 1:130 EAST 77TH STREET
Practice Address - Street 2:BLACK HALL, 13TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075
Practice Address - Country:US
Practice Address - Phone:908-878-8663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program