Provider Demographics
NPI:1821001728
Name:MOHAMMADI, SHAHRZAD (MD)
Entity Type:Individual
Prefix:
First Name:SHAHRZAD
Middle Name:
Last Name:MOHAMMADI
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:ONE HOSPITAL PLAZA
Mailing Address - Street 2:THE STAMFORD HOSPITAL
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06904-9317
Mailing Address - Country:US
Mailing Address - Phone:203-276-7831
Mailing Address - Fax:203-276-7548
Practice Address - Street 1:ONE HOSPITAL PLAZA
Practice Address - Street 2:THE STAMFORD HOSPITAL
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06904-9317
Practice Address - Country:US
Practice Address - Phone:203-276-7831
Practice Address - Fax:203-276-7548
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT036747208000000X
NY209918208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2V3302OtherHEALTH NET
TINOtherFOCUS
CT1793250OtherCIGNA
TINOtherCONSUMER HEALTH NETWORK
CT2120207OtherFIRST HEALTH / CCN
CT767457OtherCONNECTICARE
TINOtherNEHCA
CT010036747CT01OtherANTHEM BC/BS
TINOtherMULTIPLAN
CT7585379OtherAETNA
TINOtherWELLCARE
CT2215007OtherUNITED HEALTHCARE
CT5B8191OtherEMPIRE BC/BS
CTP2670279OtherOXFORD HEALTH PLAN
TINOtherGREAT WEST
TINOtherMANAGED CARE STATEGIES
TINOtherPIONEER