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Contact Information

MANOOCHEHR MAZLOOMDOOST PSC
101 N EAGLE CREEK DR # 120
LEXINGTON, KY40509-1806
 Phone: 859-275-4878
 Fax: 859-276-5400
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Pain Medicine

2084P2900X 86 Physician/Neuropsychiatry
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MANOOCHEHR MAZLOOMDOOST PSC · (Female)

NPI Number 1770555492
Status Active
Credentials
Entity Individual
Enumeration date 02/06/2006
Last updated 07/18/2024 - More than a year ago
Sole proprietor 1 Not specified
Identifiers
  • KY Medicaid 65941387
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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