Provider Demographics
NPI:1831940212
Name:NASEEM B. RAZAVI, MD LLC
Entity type:Organization
Organization Name:NASEEM B. RAZAVI, MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NASEEM
Authorized Official - Middle Name:B
Authorized Official - Last Name:RAZAVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-310-9549
Mailing Address - Street 1:36 RUSS ST FL 3
Mailing Address - Street 2:STE 738
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-1520
Mailing Address - Country:US
Mailing Address - Phone:860-310-9549
Mailing Address - Fax:
Practice Address - Street 1:36 RUSS ST FL 3
Practice Address - Street 2:STE 738
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-1520
Practice Address - Country:US
Practice Address - Phone:301-785-2099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty