Fazle Azeem, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

109585-01 Issued in NY

Practice address

5015 Beach Channel Dr
Far Rockaway, NY 11691-1110

Phone

(718) 734-2000

NPI assigned

May 27, 2021

Last updated

Nov 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• MD Fazle Azeem Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • NPI 1821986688
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730592000000",
    "number": "1760057194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 DORA ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103142107",
            "telephone_number": "917-202-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 BEACH CHANNEL DR",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911110",
            "telephone_number": "718-734-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZEEM",
        "first_name": "FAZLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-27",
        "last_updated": "2024-11-03",
        "certification_date": "2024-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "109585-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MD",
            "last_name": "AZEEM",
            "middle_name": "FAZLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tugba Ay
• Ivette Ayala
• Victoria Ayala, MD
• Abul Kalam Azad, M.D.
• Najiib M Azad, D.O.
• Ariella Esther Babad, LCSW-R
• Makhrulakhon Babaeva, MD
• Yuliya Babakhanova
• Kerry Valene Bacchus, NURSE
• Avigail Hanna Bachayev

• Internal Medicine Physician in Far Rockaway, NY
• Providers in Far Rockaway, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.