Most Relevant Information
Provider Data
| NPI Number: | 1003545377 |
| Provider Name: | SUBOOR AZIMI |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 068386 |
Most Important Dates
| Enumeration Date: | 06/10/2022 |
| Last Updated: | 06/10/2022 |
Provider Practice Location
101 SAINT ANDREWS LN
GLEN COVE
NY
115422263
Practice Location Phone/Fax
| Phone: | 5166747300 |
| Fax: |
Provider Mailing Location
1 PRISCILLA LN
PORT JEFFERSON STATION
NY
117764219
Provider Mailing Phone/Fax
| Phone: | 5163485759 |
| Fax: |