Provider Demographics
NPI:1831200245
Name:DEPAZ, HECTOR (MD)
Entity type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:
Last Name:DEPAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 MALCOLM X BLVD
Mailing Address - Street 2:DEPARTMENT OF SURGERY, HARLEM HOSPITAL CENTER
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1802
Mailing Address - Country:US
Mailing Address - Phone:212-939-8039
Mailing Address - Fax:212-939-3536
Practice Address - Street 1:506 MALCOLM X BLVD
Practice Address - Street 2:DEPARTMENT OF SURGERY, HARLEM HOSPITAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1802
Practice Address - Country:US
Practice Address - Phone:212-939-8039
Practice Address - Fax:212-939-3536
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214156208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH16079Medicare UPIN
NY91L681Medicare ID - Type Unspecified