Individual
SEYED SHAHAB JAZAYERI MOGHADDAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
56 FRANKLIN ST, WATERBURY, CT 06706-1253
(203) 709-8685
Mailing address
1711 S 3RD ST, LOUISVILLE, KY 40208-1917
(502) 322-2241
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
69806
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/18/2019
Last updated
06/13/2022
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