Provider Demographics
NPI:1225922826
Name:LEFKOWITZ-DAZA, NATALIE ANIYAH
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANIYAH
Last Name:LEFKOWITZ-DAZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 ARRINGDON PARK DR STE 300
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5677
Mailing Address - Country:US
Mailing Address - Phone:704-307-3170
Mailing Address - Fax:
Practice Address - Street 1:5601 ARRINGDON PARK DR STE 300
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-5677
Practice Address - Country:US
Practice Address - Phone:704-307-3170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-15409363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical