Individual
AVISHEH FOROUZESH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
331 GRAND ST, GROUND FLOOR, HOBOKEN, NJ 07030-2719
(201) 238-2888
Mailing address
330 WASHINGTON ST, PMB #603, HOBOKEN, NJ 07030-4883
(201) 238-2888
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
232351
NY
207RI0200X
Infectious Disease Physician
Primary
25MA 09020700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232351
LICENSE
NY
Enumeration date
07/09/2006
Last updated
11/13/2014
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