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NPI Code Detail

MEDICARE: ALI TORABZADEH M.D.

MEDICARE: ALI TORABZADEH M.D.
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
1207Q00000XFamily Medicine Physician045914CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11710176631OTHERNPI

General Provider Information

NPI Number : 1710176631
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALI TORABZADEH M.D.
Provider Business Mailing Address
First Line : 339 W MAIN ST
Second Line :
City : AVON
State : CT
Zip : 06001-4322
Country : US
Telephone Number : 860-696-2150
Fax Number : 860-696-2160
Provider Business Practice Location Address
First Line : 339 W MAIN ST
Second Line :
City : AVON
State : CT
Zip : 06001-4322
Country : US
Telephone Number : 860-696-2150
Fax Number : 860-696-2160
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2007
Last Update Date : 09/23/2011

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Directions to “ ALI TORABZADEH M.D.” Practice Location

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