Fred Rezvani is a Specialist in Ridgewood, New Jersey. Fred Rezvani practices all healthcare services and medical treatments related to Specialist. The NPI Number for Fred Rezvani is 1104887694. The last update date is 2008-04-16.
Fred Rezvani's current location address is 119 Prospect St, Ridgewood, New Jersey. You can contact this provider via phone number 2014441600 and fax number 2014448774. The mailing address for Fred Rezvani is 119 Prospect St, Ridgewood, New Jersey. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Fred Rezvani |
|---|---|
| Address | 119 Prospect St, Ridgewood, New Jersey |
| Phone Number | 2014441600 |
| Fax Number | 2014448774 |
| Sole Proprietor | N |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1104887694 |
|---|---|
| Provider Enumeration Date | 2006-04-01 |
| Last Updated Date | 2008-04-16 |
Provider Mailing Address Detail
| Address | 119 Prospect St |
|---|---|
| City | Ridgewood |
| State | New Jersey (NJ) |
| Post Code | 74504405 |
| Phone Number | 2014441600 |
| Fax Number | 2014448774 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 25MA05115800 |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 28398 | NJ | AETNA HMO # | |
| 562861001 | NJ | AMERIHEALTH # | |
| 0K6927 | NJ | HEALTHNET # | |
| 30G161 | NJ | EMPIRE BC/BS OF NY | |
| 4226530 | NJ | AETNA PPO # | |
| BP204 | NJ | OXFORD ID# |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Fred Rezvani by the Centers for Medicare & Medicaid Services?
The Fred Rezvani has been issued the NPI (National Provider Identifier) 1104887694, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Fred Rezvani's facilities are situated?
The facilities of Fred Rezvani are physically located at the following address: 119 Prospect St, Ridgewood, NJ, 74504405.
What is Fred Rezvani's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Fred Rezvani is Specialist, and the corresponding taxonomy classification code for this specialized field is 174400000X.
When did Fred Rezvani receive its 1104887694 assignment?
The Fred Rezvani was assigned its 1104887694 on 2006-04-01, which is the date when this unique identifier was issued to the organization.
When was the information pertaining to Fred Rezvani most recently updated or revised?
The details related to Fred Rezvani, including its address, specialty, and other relevant information, were last updated or revised on 2008-04-16.
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