Provider Demographics
NPI:1932249943
Name:FIROZ, BAHAR FATEMEH (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:BAHAR
Middle Name:FATEMEH
Last Name:FIROZ
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WORLDS FAIR DR STE 2400
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1344
Mailing Address - Country:US
Mailing Address - Phone:732-235-3505
Mailing Address - Fax:
Practice Address - Street 1:1 WORLDS FAIR DR STE 2400
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1344
Practice Address - Country:US
Practice Address - Phone:732-235-3505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242285207N00000X
TXM9278207ND0101X
NJ25MA08985000207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJPTANOther242350CKD
204479402OtherCSHCN
UT204479401Medicaid
UT204479401Medicaid
TX8L16424Medicare PIN