Provider Demographics
NPI:1235477290
Name:RADJABI, AMIR REZA (MD)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:REZA
Last Name:RADJABI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 CENTRAL PARK S APT 1P
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1429
Mailing Address - Country:US
Mailing Address - Phone:212-535-5350
Mailing Address - Fax:
Practice Address - Street 1:240 CENTRAL PARK S APT 1P
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1429
Practice Address - Country:US
Practice Address - Phone:212-535-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-27
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282596207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology