Individual
IRAJ REZVANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
ERIE AVE AT FRONT ST, SCPA ENDOCRINOLOGY, PHILADELPHIA, PA 19134-1095
(215) 427-8822
(215) 427-8830
Mailing address
ERIE AVE AT FRONT ST, SCPA ENDOCRINOLOGY, PHILADELPHIA, PA 19134-1095
(215) 427-8822
(215) 427-8830
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
MD033063L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006658770004
—
PA
Enumeration date
10/13/2005
Last updated
09/27/2007
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