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Contact Information

FIROOZ REZVANI, MD
640 BELLE TERRE RD
BLDG J
PORT JEFFERSON, NY11777
 Phone: 631-928-2121
 Fax: 631-928-2127
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for FIROOZ REZVANI · (Male)

NPI # 1376650465
Status Active
Credentials MD
Entity Individual
Enumeration date 08/24/2006
Last updated 01/05/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 128733
  • NY Medicaid 00646295
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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