Basic Information
| Provider Information | |||||||||
| NPI: | 1922335298 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AZIZ | ||||||||
| FirstName: | RANIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 185 S ORANGE AVE | ||||||||
| Address2: | MSB E-538 | ||||||||
| City: | NEWARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 071032757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9739725007 | ||||||||
| FaxNumber: | 9739720582 | ||||||||
| Practice Location | |||||||||
| Address1: | 185 S ORANGE AVE | ||||||||
| Address2: | MSB E-538 | ||||||||
| City: | NEWARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 071032757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9739725007 | ||||||||
| FaxNumber: | 9739720582 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2009 | ||||||||
| LastUpdateDate: | 01/01/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP3000X | 2010012187 | MO | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pediatric Anesthesiology | 207L00000X | 2010012187 | MO | N | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 1922335298 | 05 | MO | MEDICAID |