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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 5 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 1306451695 NPPES
Pennsylvania MEDICAID 23-1352685
Pennsylvania MEDICAID 45862287

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