Individual provider · Type 1 NPI

Dimitri Bazin, PA

Medical Physician Assistant · New York, NY

NPI number 1174067425 Active

Practice location

3418 Broadway Ofc 2
New York, NY 10031-7408

Call (212) 283-2099 Map

Mailing address

565 W 125th St
New York, NY 10027-3424

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XP04485 (NY)

Medical Physician Assistant: Definition to come...

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About NPI 1174067425

Dimitri Bazin, PA's National Provider Identifier is 1174067425, issued on Dec 6, 2016. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in New York, NY. The record was last updated on Dec 6, 2016.