Provider Demographics
NPI:1396999553
Name:YASSARI, REZA (MD, MS)
Entity type:Individual
Prefix:
First Name:REZA
Middle Name:
Last Name:YASSARI
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Gender:M
Credentials:MD, MS
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Mailing Address - Street 1:3316 ROCHAMBEAU AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2841
Mailing Address - Country:US
Mailing Address - Phone:718-920-7400
Mailing Address - Fax:718-920-5010
Practice Address - Street 1:3316 ROCHAMBEAU AVE FL 5
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2841
Practice Address - Country:US
Practice Address - Phone:718-920-7400
Practice Address - Fax:718-920-5010
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.115931207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery