Individual
FIROOZ REZVANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
640 BELLE TERRE RD, BLDG J, PORT JEFFERSON, NY 11777
(631) 928-2121
(631) 928-2127
Mailing address
640 BELLE TERRE RD, BLDG J, PORT JEFFERSON, NY 11777
(631) 928-2121
(631) 928-2127
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
128733
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00646295
—
NY
Enumeration date
08/24/2006
Last updated
01/05/2011
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