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General NPI Number Information
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NPI Number | 1972643328
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Entity Type | Individual
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Provider Name | MARZIE TAGHAVI NEJAD MD
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | THREE TIMBERLINE DRIVE
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City | ALPINE
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State | NJ
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Zip | 07620
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Country | US
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Telephone | 201-784-3759
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Fax |
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Provider Business Mailing Address
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Address Line | 462 1ST AVENUE 5N
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City | NEW YORK
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State | NY
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Zip | 10016
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Country | US
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Telephone | 212-562-5254
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Fax | 212-562-3503
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 133682
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License Number State | NY
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