Provider Demographics
NPI:1255501375
Name:AZER, WAGEEH W (MD)
Entity type:Individual
Prefix:DR
First Name:WAGEEH
Middle Name:W
Last Name:AZER
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 1:579 CRANBURY RD STE G
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5408
Mailing Address - Country:US
Mailing Address - Phone:732-481-1599
Mailing Address - Fax:
Practice Address - Street 1:579 CRANBURY RD STE G
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5408
Practice Address - Country:US
Practice Address - Phone:327-481-1599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235162208600000X
NJ25NA08187800208600000X
NJ25MA08187800208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0440159Medicaid