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General NPI Number Information
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NPI Number | 1831315308
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Entity Type | Organization
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Legal Business Name | DR. R. MOSTAFAVI, OPHTHALMOLOGIST PC
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 14 BLEEKER PL
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City | STATEN ISLAND
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State | NY
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Zip | 10314-3727
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Country | US
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Telephone | 718-809-6679
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Fax |
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Provider Business Mailing Address
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Address Line | 14 BLEEKER PL
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City | STATEN ISLAND
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State | NY
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Zip | 10314-3727
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Country | US
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Telephone | 718-809-6679
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAMIN MOSTAFAVI
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Credential | M.D.
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Telephone | 718-809-6679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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