Provider Demographics
NPI:1013457043
Name:PARTOVITABAR, PARNAZ
Entity Type:Individual
Prefix:
First Name:PARNAZ
Middle Name:
Last Name:PARTOVITABAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1396 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-4513
Mailing Address - Country:US
Mailing Address - Phone:718-919-1000
Mailing Address - Fax:
Practice Address - Street 1:1396 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-4513
Practice Address - Country:US
Practice Address - Phone:718-919-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant