Provider Demographics
NPI:1215127170
Name:PERVIN, AFROZ (MD)
Entity type:Individual
Prefix:DR
First Name:AFROZ
Middle Name:
Last Name:PERVIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9712 63RD DR
Mailing Address - Street 2:SUITE # CA
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2243
Mailing Address - Country:US
Mailing Address - Phone:718-830-3388
Mailing Address - Fax:718-559-4826
Practice Address - Street 1:9712 63RD DR
Practice Address - Street 2:SUITE # CA
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2243
Practice Address - Country:US
Practice Address - Phone:718-830-3388
Practice Address - Fax:718-559-4826
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245333207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine