MEDICARE: DR. REZA ZARNEGAR D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	239736	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164651519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REZA ZARNEGAR D.O.

Provider Business Mailing Address
First Line	:	PO BOX 1244
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10113-1244
Country	:	US
Telephone Number	:	646-330-8943
Fax Number	:

Provider Business Practice Location Address
First Line	:	7206 NORTHERN BLVD
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-1049
Country	:	US
Telephone Number	:	718-670-1512
Fax Number	:	718-747-1262

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2009
Last Update Date	:	06/02/2023

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