Provider Demographics
NPI:1730351792
Name:ABDELAZIZ, ABDALLA H (BVSC)
Entity type:Individual
Prefix:DR
First Name:ABDALLA
Middle Name:H
Last Name:ABDELAZIZ
Suffix:
Gender:M
Credentials:BVSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-4131
Mailing Address - Country:US
Mailing Address - Phone:973-641-4061
Mailing Address - Fax:
Practice Address - Street 1:1347 BROAD ST
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-4221
Practice Address - Country:US
Practice Address - Phone:973-777-0064
Practice Address - Fax:973-777-8436
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ29VI04938174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian