Provider Demographics
NPI:1417454190
Name:NAJMI VARZANEH, FARNAZ (MD)
Entity Type:Individual
Prefix:
First Name:FARNAZ
Middle Name:
Last Name:NAJMI VARZANEH
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 1:21 EDGEWATER CIR
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:CT
Mailing Address - Zip Code:06037-5031
Mailing Address - Country:US
Mailing Address - Phone:443-333-7563
Mailing Address - Fax:
Practice Address - Street 1:21 EDGEWATER CIR
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:CT
Practice Address - Zip Code:06037-5031
Practice Address - Country:US
Practice Address - Phone:433-337-5634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT631362085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program