Provider Demographics
NPI:1932088416
Name:HAJ HOSSEIN TALASAZ, AZITA (PHARMD, PHD)
Entity type:Individual
Prefix:
First Name:AZITA
Middle Name:
Last Name:HAJ HOSSEIN TALASAZ
Suffix:
Gender:F
Credentials:PHARMD, PHD
Other - Prefix:
Other - First Name:AZITA
Other - Middle Name:
Other - Last Name:TALASAZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD, PHD
Mailing Address - Street 1:622 W 168TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:622 W 168TH ST APT 5C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0710901835C0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835C0206XPharmacy Service ProvidersPharmacistCardiology