Provider Demographics
NPI:1558690594
Name:PARVIZ B. MEHRI, M.D., F.A.C.S., P.C.
Entity Type:Organization
Organization Name:PARVIZ B. MEHRI, M.D., F.A.C.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PARVIZ
Authorized Official - Middle Name:B
Authorized Official - Last Name:MEHRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-748-2020
Mailing Address - Street 1:2 GLEN HILL RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-4906
Mailing Address - Country:US
Mailing Address - Phone:203-748-2020
Mailing Address - Fax:203-744-4333
Practice Address - Street 1:2 GLEN HILL RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-4906
Practice Address - Country:US
Practice Address - Phone:203-748-2020
Practice Address - Fax:203-744-4333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT011332174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB06654Medicare UPIN