Provider Demographics
NPI:1114932936
Name:MUMTAZ RAJABALI KARIMI, PHYSICIAN, PC
Entity Type:Organization
Organization Name:MUMTAZ RAJABALI KARIMI, PHYSICIAN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUMTAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:KARIMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-487-1124
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14702-0041
Mailing Address - Country:US
Mailing Address - Phone:716-487-1124
Mailing Address - Fax:716-487-2488
Practice Address - Street 1:207 FOOTE AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-7077
Practice Address - Country:US
Practice Address - Phone:716-487-0141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02047441Medicaid
NYH01838Medicare UPIN
NYJ100000008Medicare PIN
NYCC0464Medicare PIN
NYDN7230Medicare PIN