Provider Demographics
NPI:1053138354
Name:ARIEL AMIRZADEH FAMILY HEALTH NP PLLC
Entity type:Organization
Organization Name:ARIEL AMIRZADEH FAMILY HEALTH NP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIRZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-832-9294
Mailing Address - Street 1:121 HAMPSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1230
Mailing Address - Country:US
Mailing Address - Phone:347-832-2994
Mailing Address - Fax:
Practice Address - Street 1:121 HAMPSHIRE RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-1230
Practice Address - Country:US
Practice Address - Phone:347-832-2994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-26
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service