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General NPI Number Information
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NPI Number | 1073567749
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Entity Type | Individual
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Provider Name | FARROKH KHAJAVI-NOORI MD
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 11/26/2007
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Provider Practice Location Address
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Address Line | 3 WOODLAND RD STE 418 STE 418
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City | STONEHAM
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State | MA
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Zip | 02180-1714
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Country | US
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Telephone | 781-662-6213
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Fax | 781-665-9860
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Provider Business Mailing Address
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Address Line | 3 WOODLAND RD #418
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City | STONEHAM
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State | MA
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Zip | 02180-1714
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Country | US
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Telephone | 781-662-6213
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Fax | 781-665-9860
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 34309
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License Number State | MA
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