1740480227 NPI number — FIROZ LALANI

Table of content: FIROZ LALANI (NPI 1740480227)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740480227 NPI number — FIROZ LALANI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LALANI
Provider First Name:
FIROZ
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740480227
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/23/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2785 LAWRENCEVILLE HWY
Provider Second Line Business Mailing Address:
STE 103
Provider Business Mailing Address City Name:
DECATUR
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30033-2515
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-491-1132
Provider Business Mailing Address Fax Number:
850-837-2042

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2785 LAWRENCEVILLE HWY
Provider Second Line Business Practice Location Address:
STE 103
Provider Business Practice Location Address City Name:
DECATUR
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30033-2515
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-491-1132
Provider Business Practice Location Address Fax Number:
850-837-2042
Provider Enumeration Date:
07/23/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  DN013555 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)