FIROOZ REZVANI (NPI# 1376650465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376650465 |
| Entity Type | Individual |
| Full Name | FIROOZ REZVANI |
| Credential | MD |
| Practice Address |
640 Belle Terre Rd Bldg J Port Jefferson NY 11777 |
| Practice Telephone | 6319282121 |
| Practice Fax Number | 6319282127 |
| Mailing Telephone | 6319282121 |
| Mailing Fax Number | 6319282127 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2011-01-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 128733 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00646295 | 05 |
| Street Address |
640 BELLE TERRE RD BLDG J |
| City | PORT JEFFERSON |
| State | NY |
| Zip Code | 11777 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053365585 | Christopher Beatty, Md, PC | Surgery | 640 Belle Terre Rd, Port Jefferson, NY 11777-1936 | 2006-05-20 |
| 1932441755 | Jacqueline Lemanski | Social Worker | 640 Belle Terre Rd, Port Jefferson, NY 11777-1936 | 2013-03-19 |
| 1700195351 | Salim A Matar Md PC | Otolaryngology | 640 Belle Terre Rd, Building C, Port Jefferson, NY 11777-1936 | 2010-09-30 |
| 1285813667 | Robert M Woznicki Md PC | Psychiatry & Neurology | 640 Belle Terre Rd, Bldg J3, Port Jefferson, NY 11777-1936 | 2007-11-01 |
| 1548458599 | Gisou Saffari | Massage Therapist | 640 Belle Terre Rd, Bldg E, Port Jefferson, NY 11777-1936 | 2007-10-03 |
| 1972637544 | Mary Flammer | Massage Therapist | 640 Belle Terre Rd, Bldg E, Port Jefferson, NY 11777-1936 | 2007-03-15 |
| 1487711636 | Susan Phelan | Nurse Practitioner | 640 Belle Terre Rd, Suite J2-3, Port Jefferson, NY 11777-1936 | 2007-01-03 |
| 1417024001 | Port Neurology PC | Specialist | 640 Belle Terre Rd, Building H, Port Jefferson, NY 11777-1936 | 2006-11-29 |
| 1154404705 | Darlene Renee Petroccione | Dietitian, Registered | 640 Belle Terre Rd, Building E, Port Jefferson, NY 11777-1936 | 2006-10-24 |
| 1588753628 | Henry J Best Iv | Family Medicine | 640 Belle Terre Rd, Bldg F, Port Jefferson, NY 11777-1936 | 2006-10-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568088615 | Aqsa Ashraf | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mather Hospital Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-24 |
| 1366068975 | Manal Ahmad | Student in an Organized Health Care Education/Training Program | 75 N County Rd, Level 2 Cmo Suite, Internal Medicine Re, Mather Hospital, Port Jefferson, NY 11777 | 2020-06-19 |
| 1639794555 | Umair Ahmad Ansari | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mother Hospital, Internal Medicine Re, Level 2 - Cmd Suite, Port Jefferson, NY 11777 | 2020-06-16 |
| 1578188132 | Manasi Sule | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Mather Hospital, Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-10 |
| 1508480716 | Imona Subedi | Student in an Organized Health Care Education/Training Program | 75 N Country Road, Level 2 - Cmo Suite, Mather Hospital Internal Medicine Residency Program, Port Jefferson, NY 11777 | 2020-06-03 |
| 1184252108 | Romana Imtiaz Syed | Student in an Organized Health Care Education/Training Program | Liza M Dominioni,mather Hospital,internal Medicine, Residency Program,level 2-cmo Suite,75 N Country Rd, Port Jefferson, NY 11777 | 2020-03-27 |
| 1649807348 | Mustafa Mohammed Abdulsada | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Ny, Level 2 - Cmo Suite, Port Jefferson, NY 11777 | 2020-03-24 |
| 1184264764 | Girma Moges Gamme | Surgery | 625 Belle Terre Rd, Suite 203 Mather Hospital, Port Jefferson, NY 11777 | 2020-01-10 |
| 1811554637 | Kausar Ali | Nurse Practitioner | 408 Thompson Street, Port Jefferson, NY 11777 | 2019-05-28 |
| 1073097531 | Ministry for Hope, Inc. Montfort Therapeutic Residence | Residential Treatment Facility, Physical Disabilities | 100 Stonyhill Road, Port Jefferson, NY 11777 | 2018-09-20 |
| Find all providers in zip 11777 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700195351 | Salim A Matar Md PC | Otolaryngology | 640 Belle Terre Rd, Building C, Port Jefferson, NY 11777-1936 | 2010-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235766361 | Ali Agarabi | Otolaryngology | 675 Westview Dr, Mattituck, NY 11952-2963 | 2020-03-26 |
| 1932739281 | Ear Nose & Throat Medical Services of New York, Pllc | Otolaryngology | 8 Quaker Ridge Rd, Glen Head, NY 11545-3326 | 2020-01-24 |
| 1669002283 | Robert I Kaplan Md Pllc | Otolaryngology | 1524 Route 9 Ste 2, Halfmoon, NY 12065-8646 | 2020-01-23 |
| 1154965648 | B Thuy Le Md P C | Otolaryngology | 589 Broadway Fl 2, New York, NY 10012-3231 | 2019-10-29 |
| 1659938959 | Tony Richa | Otolaryngology | Elm and Carlton Streets Head and Neck Surgical Oncology, Buffalo, NY 14263-0001 | 2019-05-22 |
| 1003372632 | Nancy King Md Pllc | Otolaryngology | 128 Mott St Ste 608, New York, NY 10013-5589 | 2019-02-19 |
| 1265919179 | Rian Rosen | Otolaryngology | 420 Madison Ave Rm 503, New York, NY 10017-1175 | 2018-07-24 |
| 1225514409 | Mauricio R. Milhoua | Otolaryngology | 16 Marion Place, South Huntington, NY 11746 | 2018-07-11 |
| 1003308172 | Greater Buffalo Ent | Otolaryngology | 3950 E Robinson Rd Ste 106, Amherst, NY 14228-2042 | 2018-06-04 |
| 1184141798 | Ofer Azoulay | Otolaryngology | 185 Montague St Fl 5, Brooklyn, NY 11201-3608 | 2017-08-24 |
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| City | PORT JEFFERSON |
| Zip Code | 11777 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.