Mahreen Abdul Razzaq, M.D.
Individual provider Active NPI Family Medicine Physician · Alexandria Bay, NY
NPI 1306016753 · NPPES record last updated Oct 27, 2011
Key facts
- NPI
- 1306016753
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 5315027646 (MI)
- Practice address
- 4 Fuller St
Alexandria Bay, NY 13607-1316 - Phone
- (315) 482-1100
- NPI assigned
- Feb 29, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5315027646 | MI | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5315027646 | MI | Yes |
Addresses
Primary practice location
4 Fuller St
Alexandria Bay, NY 13607-1316
Mailing address
4 Fuller St
Alexandria Bay, NY 13607-1316
Phone (315) 482-1100
Other providers in Alexandria Bay, NY
- Blair Richelle Rose Perruccio
- Emily Wiley Peters
- Natalie Kathryn Powers
- Jessica Lauren Rafter
- Natalie Ramsdell
- Rhody L Spooner Optical Services
- River Hospital, Inc.
- River Hospital, Inc.
- River Hospital, Inc.
- River Hospital, Inc.
All providers in Alexandria Bay, NY · Family Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2011. 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.