Individual
DR. MOHAMMADREZA AZADFARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MT190346
PA
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
258521
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03292197
—
NY
Enumeration date
05/12/2008
Last updated
06/29/2023
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