Provider Demographics
NPI:1326800921
Name:MOZAFFARI, AFSANEH
Entity Type:Individual
Prefix:
First Name:AFSANEH
Middle Name:
Last Name:MOZAFFARI
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 1:18357 W ELWOOD ST
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-7592
Mailing Address - Country:US
Mailing Address - Phone:602-435-0281
Mailing Address - Fax:
Practice Address - Street 1:18357 W ELWOOD ST
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-7592
Practice Address - Country:US
Practice Address - Phone:602-435-0281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle