Azizi-Ghannad, Sadra
Azizi-Ghannad, Sadra is an individual health care provider with primary practice located at 2015 Grand Concourse , Bronx NY 10453-4303. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Azizi-Ghannad, Sadra can be contacted via phone (718) 299-7295.Contact Information
Primary practice address
2015 Grand Concourse
Bronx NY 10453-4303
Phone: (718) 299-7295
Fax: (718) 299-6797
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 283619 | New York |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 87720 | South Carolina |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 01085009A | Indiana |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 283619 | New York |
Profile Details
| NPI number | 1639435084 |
|---|---|
| LBN Legal business name | Azizi-Ghannad, Sadra |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 10th, 2012 |
| Last updated | Nov 4th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639435084 | NPPES |
| New York | MEDICAID | 04443367 |
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