Individual
MISS KIANA YAZDIFARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
300 STAFFORD ST STE 200, SPRINGFIELD, MA 01104-3581
(516) 524-8308
Mailing address
2 PERKINS SQ APT 9, JAMAICA PLAIN, MA 02130-1708
15165248308
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
08/25/2017
Last updated
08/29/2017
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