Provider Demographics
NPI:1285710731
Name:HAZARI, NIRAJ D (MSPT)
Entity type:Individual
Prefix:MR
First Name:NIRAJ
Middle Name:D
Last Name:HAZARI
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2483 OLD MIDDLEFIELD WAY STE 180
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-2359
Mailing Address - Country:US
Mailing Address - Phone:650-967-5100
Mailing Address - Fax:650-967-5101
Practice Address - Street 1:2483 OLD MIDDLEFIELD WAY STE 180
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-2359
Practice Address - Country:US
Practice Address - Phone:650-967-5100
Practice Address - Fax:650-967-5101
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT25311225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT253110Medicare ID - Type Unspecified