Provider Demographics
NPI:1144091257
Name:UDDIN, AZIR
Entity type:Individual
Prefix:
First Name:AZIR
Middle Name:
Last Name:UDDIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 FELLNER PL
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-2120
Mailing Address - Country:US
Mailing Address - Phone:973-653-7324
Mailing Address - Fax:
Practice Address - Street 1:1611 E 19TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1301
Practice Address - Country:US
Practice Address - Phone:347-234-7645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator