Provider Demographics
NPI:1881157659
Name:AL BAWAB, ABDEL AZIZ (MD)
Entity type:Individual
Prefix:DR
First Name:ABDEL AZIZ
Middle Name:
Last Name:AL BAWAB
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 1:35 W 110TH ST APT 4A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-4363
Mailing Address - Country:US
Mailing Address - Phone:505-239-1251
Mailing Address - Fax:
Practice Address - Street 1:234 E 149TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5589
Practice Address - Country:US
Practice Address - Phone:718-579-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2025-06-26
Deactivation Date:2019-11-27
Deactivation Code:
Reactivation Date:2020-01-02
Provider Licenses
StateLicense IDTaxonomies
NY3229902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry