Individual
MOJTABA MIRZAEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
160 ROBBINS ST, WATERBURY, CT 06708-2652
(203) 573-7284
(203) 573-7031
Mailing address
64 ROBBINS ST, WATERBURY, CT 06708-2613
(203) 573-6162
(203) 573-6707
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
70250
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2019
Last updated
05/04/2022
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