Provider Demographics
NPI:1871387712
Name:ESHAQ, ABDULAZIZ MOHAMMED SALEM
Entity type:Individual
Prefix:
First Name:ABDULAZIZ
Middle Name:MOHAMMED SALEM
Last Name:ESHAQ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2157 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-2692
Mailing Address - Country:US
Mailing Address - Phone:716-862-1423
Mailing Address - Fax:716-862-1871
Practice Address - Street 1:2157 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-2692
Practice Address - Country:US
Practice Address - Phone:716-862-1423
Practice Address - Fax:716-862-1871
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program