Provider Demographics
NPI:1982336871
Name:MIRZA, HAJIRA IFTIKHEU (MD)
Entity Type:Individual
Prefix:
First Name:HAJIRA
Middle Name:IFTIKHEU
Last Name:MIRZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 FORBES AVENUE, FORBES TOWER
Mailing Address - Street 2:PLAZA LEVEL SUITE 140
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:330-363-6223
Mailing Address - Fax:330-453-4263
Practice Address - Street 1:POLY CLINICAL 2501 N. 3RD STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110
Practice Address - Country:US
Practice Address - Phone:330-363-6223
Practice Address - Fax:330-453-4263
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-29
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program