Healthcare Provider Details

I. General information

NPI: 1336471259
Provider Name (Legal Business Name): ALIREZA REZAEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2010
Last Update Date: 02/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

648 MOREWOOD AVE
PITTSBURGH PA
15213-2910
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-5690
  • Fax: 216-444-1162
Mailing address:
  • Phone: 412-918-1534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: