Provider Demographics
NPI:1760479190
Name:HAJIZADEH, NEGIN (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:NEGIN
Middle Name:
Last Name:HAJIZADEH
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:GREENPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11944-1213
Mailing Address - Country:US
Mailing Address - Phone:401-935-1027
Mailing Address - Fax:
Practice Address - Street 1:330 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:GREENPORT
Practice Address - State:NY
Practice Address - Zip Code:11944-1213
Practice Address - Country:US
Practice Address - Phone:401-935-1027
Practice Address - Fax:212-562-1759
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT045761207RC0200X, 207RP1001X
MA223022207RC0200X, 207RP1001X
NY262641207RP1001X
MA216903207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2106451Medicaid
MA2106451Medicaid
I33894Medicare UPIN