Provider Demographics
NPI:1376778217
Name:FIROZ, ELNAZ F (MD)
Entity Type:Individual
Prefix:
First Name:ELNAZ
Middle Name:F
Last Name:FIROZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 SUMMIT AVENUE
Mailing Address - Street 2:FAIN BUILDING, SUITE 2C
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906
Mailing Address - Country:US
Mailing Address - Phone:401-444-7959
Mailing Address - Fax:
Practice Address - Street 1:164 SUMMIT AVENUE
Practice Address - Street 2:FAIN BUILDING, SUITE 2C
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906
Practice Address - Country:US
Practice Address - Phone:401-444-7959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD16436207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology