Provider Demographics
NPI:1114241999
Name:MOUSAVI, NEGAREH
Entity Type:Individual
Prefix:DR
First Name:NEGAREH
Middle Name:
Last Name:MOUSAVI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804-ONE EVERGREEN PLACE
Mailing Address - Street 2:
Mailing Address - City:WINNIPEG
Mailing Address - State:MB
Mailing Address - Zip Code:R3L 0E9
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1804-ONE EVERGREEN PLACE
Practice Address - Street 2:
Practice Address - City:WINNIPEG
Practice Address - State:MB
Practice Address - Zip Code:R3L 0E9
Practice Address - Country:CA
Practice Address - Phone:204-956-5001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program