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NPI Code Detail

MEDICARE: SEYEDEH TANNAZ MIRHOSSEINI GHAMSARI

MEDICARE: SEYEDEH TANNAZ MIRHOSSEINI GHAMSARI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1669309555
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEYEDEH TANNAZ MIRHOSSEINI GHAMSARI
Provider Business Mailing Address
First Line : 1620 SANSOM ST APT 902
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19103-5970
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1600 ROCKLAND RD
Second Line :
City : WILMINGTON
State : DE
Zip : 19803-3607
Country : US
Telephone Number : 302-651-4500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2026
Last Update Date : 05/06/2026

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