Provider Demographics
NPI:1548420839
Name:VAZIRI, FARIDEH (MD)
Entity Type:Individual
Prefix:
First Name:FARIDEH
Middle Name:
Last Name:VAZIRI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FARIDEH
Other - Middle Name:V
Other - Last Name:AMIRI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 OVERLOOK ROAD
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:NJ
Mailing Address - Zip Code:07620
Mailing Address - Country:US
Mailing Address - Phone:201-767-9284
Mailing Address - Fax:201-750-9606
Practice Address - Street 1:1 OVERLOOK ROAD
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:NJ
Practice Address - Zip Code:07620
Practice Address - Country:US
Practice Address - Phone:201-767-9284
Practice Address - Fax:201-750-9606
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA23682208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics