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General NPI Number Information
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NPI Number | 1235424086
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Entity Type | Individual
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Provider Name | FANNY MOJDEH ELAHI MD, PHD
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Gender | Female
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Dates
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Enumeration Date | 06/09/2011
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Last Update Date | 07/13/2022
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Provider Practice Location Address
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Address Line | 1 GUSTAVE L LEVY PL
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City | NEW YORK
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State | NY
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Zip | 10029-6504
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Country | US
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Telephone | 212-241-6741
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Fax |
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Provider Business Mailing Address
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Address Line | UCSF MEMORY AND AGING PO BOX 1207
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-1207
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Country | US
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Telephone | 415-476-5591
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Fax |
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | A125494
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 317687
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License Number State | NY
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