Israa Bazzi
Individual provider Active NPI Pharmacist · Brooklyn, MI
NPI 1295690394 · NPPES record last updated Dec 19, 2025
Key facts
- NPI
- 1295690394
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302418212 (MI)
- Practice address
- 414 S Main St
Brooklyn, MI 49230-9368 - Phone
- (517) 592-2115
- NPI assigned
- Dec 19, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302418212 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodward Detroit CVS, L.L.C. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302418212 | MI | Yes |
Addresses
Primary practice location
414 S Main St
Brooklyn, MI 49230-9368
Mailing address
5250 Orchard Ave
Dearborn, MI 48126-4620
Phone (313) 404-8174
Other providers in Brooklyn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.