Rezvani, Fred

Rezvani, Fred is an individual health care provider with primary practice located at 119 Prospect St , Ridgewood NJ 07450-4405. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Rezvani, Fred can be contacted via phone (201) 444-1600.

Contact Information

Primary practice address
119 Prospect St Ridgewood NJ 07450-4405
Phone: (201) 444-1600
Fax: (201) 444-8774
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 25MA05115800 New Jersey

Profile Details

NPI number 1104887694
LBN Legal business name Rezvani, Fred
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 1st, 2006
Last updated Apr 16th, 2008 - about 18 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 1104887694 NPPES
New Jersey Other 0028398 AETNA HMO #
New Jersey Other 0562861001 AETNA HMO #
New Jersey Other 0K6927 AETNA HMO #
New Jersey Other 30G161 AETNA HMO #
New Jersey Other 4226530 AETNA HMO #
New Jersey Other BP204 AETNA HMO #

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