Soroush, Azam

Soroush, Azam is an individual health care provider with primary practice located at 61 Davis Ave Ste 1, Neptune NJ 07753-4401. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as his primary health care specialty. Soroush, Azam can be contacted via phone (732) 776-4860.

Contact Information

Primary practice address
61 Davis Ave Ste 1 Neptune NJ 07753-4401
Phone: (732) 776-4860
Fax: (732) 776-4867
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X 25MA06860600 New Jersey

Profile Details

NPI number 1720057318
LBN Legal business name Soroush, Azam
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2006
Last updated Jan 24th, 2017 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720057318 NPPES
New Jersey MEDICAID 7232306

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