Provider Demographics
NPI:1578709192
Name:RAFI, REZVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:REZVAN
Middle Name:
Last Name:RAFI
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 1:2476 MALEHORN RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:19425-3306
Mailing Address - Country:US
Mailing Address - Phone:610-458-6428
Mailing Address - Fax:
Practice Address - Street 1:2476 MALEHORN RD
Practice Address - Street 2:
Practice Address - City:CHESTER SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:19425-3306
Practice Address - Country:US
Practice Address - Phone:610-458-6428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-02
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417884207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology