Rezvani, Firooz

Rezvani, Firooz is an individual health care provider with primary practice located at 640 Belle Terre Rd Bldg J, Port Jefferson NY 11777. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Rezvani, Firooz can be contacted via phone (631) 928-2121.

Contact Information

Primary practice address
640 Belle Terre Rd Bldg J Port Jefferson NY 11777
Phone: (631) 928-2121
Fax: (631) 928-2127
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 128733 New York

Profile Details

NPI number 1376650465
LBN Legal business name Rezvani, Firooz
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2006
Last updated Jan 5th, 2011 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376650465 NPPES
New York MEDICAID 00646295

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