Provider Demographics
NPI:1205221603
Name:DAVARIFAR, ARDY (MD/PHD)
Entity Type:Individual
Prefix:DR
First Name:ARDY
Middle Name:
Last Name:DAVARIFAR
Suffix:
Gender:M
Credentials:MD/PHD
Other - Prefix:DR
Other - First Name:ARDALAN
Other - Middle Name:
Other - Last Name:DAVARIFAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:177 FORT WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3733
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1926 ALCOA HWY STE 350
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1550
Practice Address - Country:US
Practice Address - Phone:865-305-8780
Practice Address - Fax:865-305-8199
Is Sole Proprietor?:No
Enumeration Date:2015-04-02
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN65670207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology