1710125943 NPI number — DR. MAZEN MICHAEL NAYROUZ MBCHB,MSC. PEDS, DCH

Table of content: MR. RICARDO MEDINA (NPI 1821988221)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710125943 NPI number — DR. MAZEN MICHAEL NAYROUZ MBCHB,MSC. PEDS, DCH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAYROUZ
Provider First Name:
MAZEN
Provider Middle Name:
MICHAEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MBCHB,MSC. PEDS, DCH
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:
1710125943
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/26/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UNIVERSITY OF ROCHESTER MEDICAL
Provider Second Line Business Mailing Address:
601 ELMWOOD AVENUE, BOX 651
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14642-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-276-3964
Provider Business Mailing Address Fax Number:
585-461-3614

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UNIVERSITY OF ROCHESTER MEDICAL
Provider Second Line Business Practice Location Address:
601 ELMWOOD AVENUE, BOX 651
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14642-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-276-3964
Provider Business Practice Location Address Fax Number:
585-461-3614
Provider Enumeration Date:
01/26/2009

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: 390200000X , with the licence number:  PENDING ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com