1821001728 NPI number — SHAHRZAD MOHAMMADI MD

Table of content: SHAHRZAD MOHAMMADI MD (NPI 1821001728)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821001728 NPI number — SHAHRZAD MOHAMMADI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOHAMMADI
Provider First Name:
SHAHRZAD
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1821001728
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/31/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ONE HOSPITAL PLAZA
Provider Second Line Business Mailing Address:
THE STAMFORD HOSPITAL
Provider Business Mailing Address City Name:
STAMFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06904-9317
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-276-7831
Provider Business Mailing Address Fax Number:
203-276-7548

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ONE HOSPITAL PLAZA
Provider Second Line Business Practice Location Address:
THE STAMFORD HOSPITAL
Provider Business Practice Location Address City Name:
STAMFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06904-9317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-276-7831
Provider Business Practice Location Address Fax Number:
203-276-7548
Provider Enumeration Date:
08/14/2006

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: 208000000X , with the licence number:  036747 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: 209918 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2V3302 . This is a "HEALTH NET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "FOCUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1793250 . This is a "CIGNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "CONSUMER HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2120207 . This is a "FIRST HEALTH / CCN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 767457 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "NEHCA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010036747CT01 . This is a "ANTHEM BC/BS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "MULTIPLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7585379 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "WELLCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2215007 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 5B8191 . This is a "EMPIRE BC/BS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P2670279 . This is a "OXFORD HEALTH PLAN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "GREAT WEST" identifier . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "MANAGED CARE STATEGIES" identifier . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "PIONEER" identifier . This identifiers is of the category "OTHER".




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