Provider Demographics
NPI:1528206877
Name:REZVANI, ALPIN
Entity Type:Individual
Prefix:MS
First Name:ALPIN
Middle Name:
Last Name:REZVANI
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 1:309 E 90TH ST
Mailing Address - Street 2:APT.2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5244
Mailing Address - Country:US
Mailing Address - Phone:646-541-4499
Mailing Address - Fax:
Practice Address - Street 1:309 E 90TH ST
Practice Address - Street 2:APT.2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-5244
Practice Address - Country:US
Practice Address - Phone:646-541-4499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-25
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018767235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist