Nourollah-Zadeh, Farzad
Nourollah-Zadeh, Farzad is an individual health care provider with primary practice located at 3400 Civic Center Blvd , Philadelphia PA 19104-5127. He recently has only one registered license in Dental Providers / Oral Medicinist, which is considered as his primary health care specialty. Nourollah-Zadeh, Farzad can be contacted via phone (267) 307-3827.Contact Information
Primary practice address
3400 Civic Center Blvd
Philadelphia PA 19104-5127
Phone: (267) 307-3827
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral Medicinist | 125Q00000X | 23-1352685 | Pennsylvania |
Profile Details
| NPI number | 1306451695 |
|---|---|
| LBN Legal business name | Nourollah-Zadeh, Farzad |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 13th, 2020 |
| Last updated | Sep 13th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306451695 | NPPES |
| Pennsylvania | MEDICAID | 23-1352685 | |
| Pennsylvania | MEDICAID | 45862287 |
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