Individual
DR. MOHAMMAD REZA MOIENAFSHARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
644 W PUTNAM AVE, GREENWICH, CT 06830-6088
(203) 210-2810
(203) 210-2811
Mailing address
2700 WESTCHESTER AVE, PURCHASE, NY 10577-2547
(914) 607-5730
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
039581
CT
207R00000X
Internal Medicine Physician
302563
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154396893
—
CT
Enumeration date
02/17/2006
Last updated
01/25/2020
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