Provider Demographics
NPI:1396192902
Name:MOFRAD, NEDA (MD)
Entity Type:Individual
Prefix:
First Name:NEDA
Middle Name:
Last Name:MOFRAD
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 1:4600 S ULSTER ST STE 1225
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-2696
Mailing Address - Country:US
Mailing Address - Phone:720-287-3093
Mailing Address - Fax:
Practice Address - Street 1:4600 S ULSTER ST STE 1225
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-2696
Practice Address - Country:US
Practice Address - Phone:720-287-3093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1576052084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology