Provider Demographics
NPI:1619352390
Name:GHADYARY-KHORZOOGHY, FIROOZEH (MD,DPM)
Entity Type:Individual
Prefix:
First Name:FIROOZEH
Middle Name:
Last Name:GHADYARY-KHORZOOGHY
Suffix:
Gender:F
Credentials:MD,DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9145 W THUNDERBIRD RD STE 101
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4820
Mailing Address - Country:US
Mailing Address - Phone:623-815-7800
Mailing Address - Fax:623-815-7900
Practice Address - Street 1:9171 W THUNDERBIRD RD STE 101
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4872
Practice Address - Country:US
Practice Address - Phone:623-815-7800
Practice Address - Fax:623-815-7900
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPOD000899213ES0103X
PASC006661213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery