Provider Demographics
NPI:1245432657
Name:PARTOVI, PARASTOO PARTOVI
Entity Type:Individual
Prefix:MRS
First Name:PARASTOO
Middle Name:PARTOVI
Last Name:PARTOVI
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:PARASTOO
Other - Middle Name:
Other - Last Name:OBEDIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPA-C
Mailing Address - Street 1:330 PEARL ST APT 3B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-1615
Mailing Address - Country:US
Mailing Address - Phone:310-985-5181
Mailing Address - Fax:
Practice Address - Street 1:374 STOCKHOLM ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-4006
Practice Address - Country:US
Practice Address - Phone:718-486-4279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011645-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant