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NPI Code Detail

MEDICARE: DR. HEZHA SERADJI AGHDAM MD

MEDICARE: DR. HEZHA SERADJI AGHDAM MD
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
1207R00000XInternal Medicine Physician327011NY
2208M00000XHospitalist Physician327011NY

General Provider Information

NPI Number : 1821617010
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HEZHA SERADJI AGHDAM MD
Provider Business Mailing Address
First Line : 100 KINGS HWY S
Second Line :
City : ROCHESTER
State : NY
Zip : 14617-5504
Country : US
Telephone Number : 585-922-1900
Fax Number :
Provider Business Practice Location Address
First Line : 330 MOUNT AUBURN ST
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-5502
Country : US
Telephone Number : 617-492-3500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2020
Last Update Date : 04/12/2024

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