MEDICARE: DR. MANOOCHER NAJAFI

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	122300000X	Dentist	0311041	NY

General Provider Information

NPI Number	:	1396836482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANOOCHER NAJAFI

Provider Business Mailing Address
First Line	:	1751 BOSTON RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10460-4943
Country	:	US
Telephone Number	:	718-589-9562
Fax Number	:	718-617-4071

Provider Business Practice Location Address
First Line	:	1751 BOSTON RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10460-4943
Country	:	US
Telephone Number	:	718-589-9562
Fax Number	:	718-617-4071

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/08/2007

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