DR. MARIO DOUYON DE AZEVEDO M.D. NPI 1356562805

NPI Information

  • NPI: 1356562805
  • Provider Name: DR. MARIO DOUYON DE AZEVEDO, M.D.
  • Classification: Family Medicine - 207QA0401X
  • Specialization: Addiction Medicine
  • Entity Type: Individual
  • Address: 3878 STATE ROUTE 11
    SUITE 2
    MALONE, NY
    ZIP 12953
  • Phone: (518) 483-6566

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NPI Details

DR. Mario Douyon De Azevedo, M.D. is an addiction medicine family medicine in Malone, NY. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. DR. Mario Douyon De Azevedo, M.D. NPI is 1356562805. 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:

3878 STATE ROUTE 11
SUITE 2
MALONE, NY
ZIP 12953-726
Phone: (518) 483-6566

The enumeration date for this NPI number is 5/1/2007 and was last updated on 7/8/2007.

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
1207QA0401XFamily MedicineAddiction Medicine223962-1NEW YORKYes

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 Other Provider Identifier Issuer
101943719MEDICAIDNEW YORK
2G90729MEDICARE UPINNEW YORK

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: 11/21/2025

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