Keshavarz, Reza
Keshavarz, Reza is an individual health care provider with primary practice located at 1879 Madison Ave , New York NY 10035-2709. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Keshavarz, Reza can be contacted via phone (212) 423-4069.Contact Information
Primary practice address
1879 Madison Ave
New York NY 10035-2709
Phone: (212) 423-4069
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 193157 | New York |
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 2080P0204X | 193157 | New York |
Profile Details
NPI number | 1790877876 |
---|---|
LBN Legal business name | Keshavarz, Reza |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 28th, 2006 |
Last updated | Jul 8th, 2007 - about 17 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 | 1790877876 | NPPES |
New York | MEDICAID | 01596496 |
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