Provider Demographics
NPI:1912223975
Name:FEREYDOUN SHAHROKHI, M.D.
Entity Type:Organization
Organization Name:FEREYDOUN SHAHROKHI, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FEREYDOUN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHROKHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-662-9001
Mailing Address - Street 1:3 WOODLAND RD STE 200
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-1710
Mailing Address - Country:US
Mailing Address - Phone:781-662-9001
Mailing Address - Fax:781-662-3888
Practice Address - Street 1:3 WOODLAND RD STE 200
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-1710
Practice Address - Country:US
Practice Address - Phone:781-662-9001
Practice Address - Fax:781-662-3888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty