Holyspirit

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

239302 Issued in NY

Legal business name

HOLYSPIRIT

Practice address

10 E Merrick Rd
Suite 205
Valley Stream, NY 11580-5800

Phone

(516) 270-6834

NPI assigned

Jun 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Agha M Raza, M.D.

Title

Physician

Phone

(516) 270-6834

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292198400000",
    "number": "1952504979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 WALDORF AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110031522",
            "telephone_number": "516-270-3852",
            "fax_number": "516-887-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E MERRICK RD",
            "address_2": "SUITE 205",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805800",
            "telephone_number": "516-270-6834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLYSPIRIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2010-12-13",
        "status": "A",
        "authorized_official_last_name": "RAZA",
        "authorized_official_first_name": "AGHA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "516-270-6834",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "239302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1790851939",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Valley Stream, NY
• Providers in Valley Stream, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; 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.