AZAM SOROUSH MD NPI 1720057318

NPI Information

NPI: 1720057318
Provider Name: AZAM SOROUSH, MD
Classification: Pediatrics - 2080P0206X
Entity Type: Individual

Specialization: Pediatric Gastroenterology

Address:
61 DAVIS AVE
STE 1
NEPTUNE, NJ
ZIP 07753
Phone: (732) 776-4860
Get Directions

Azam Soroush, MD is a pediatric gastroenterology pediatrics in Neptune, NJ. The provider is a pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. Azam Soroush, MD NPI is 1720057318. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

61 DAVIS AVE
STE 1
NEPTUNE, NJ
ZIP 07753-401
Phone: (732) 776-4860
Fax: (732) 776-4867

The enumeration date for this NPI number is 3/16/2006 and was last updated on 1/24/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080P0206X	Pediatrics	Pediatric Gastroenterology	25MA06860600	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	7232306	MEDICAID	NEW JERSEY
2	G2506	MEDICARE UPIN	NEW JERSEY
3	204708UWH	MEDICARE PIN	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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