DR. M HOSSEIN ETEZADY (NPI# 1548249840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548249840 |
| Entity Type | Individual |
| Full Name | DR. M HOSSEIN ETEZADY |
| Credential | MD |
| Practice Address |
325 Central Ave Suite 102 Malvern PA 19355-3219 |
| Practice Telephone | 6102960142 |
| Practice Fax Number | 6106512880 |
| Mailing Telephone | 6102960142 |
| Mailing Fax Number | 6106512880 |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
MD031576L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0009930090007 | 05 | |
| PA | 0009930090009 | 05 | |
| PA | GREAT VALLEY HEALTH | 232359401 | 01 |
| PA | 0009930090008 | 05 |
| Street Address |
325 CENTRAL AVE SUITE 102 |
| City | MALVERN |
| State | PA |
| Zip Code | 19355-3219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003814260 | Rachel L. Kramer | Obstetrics & Gynecology | 325 Central Ave, Suite 100, Malvern, PA 19355-3265 | 2005-07-12 |
| 1770949901 | Nicole L Luongo | Physician Assistant | 325 Central Ave, Suite 200, Malvern, PA 19355-3265 | 2016-01-04 |
| 1013289172 | Lisa Beth Meeder | Nurse Anesthetist, Certified Registered | 325 Central Ave, Suite 200, Malvern, PA 19355-3265 | 2012-02-06 |
| 1609188879 | Nicole Elana Albert | Internal Medicine | 325 Central Ave, Suite 200, Malvern, PA 19355-3265 | 2010-07-05 |
| 1720304595 | Suzanne Sakaye Nogami | Obstetrics & Gynecology | 325 Central Ave, Suite 100, Malvern, PA 19355-3265 | 2010-04-19 |
| 1275869752 | Maura Macdonald Barr | Internal Medicine | 325 Central Ave, Suite 200, Malvern, PA 19355-3265 | 2009-10-19 |
| 1568670198 | Adam B Kaufman | Internal Medicine | 325 Central Ave, Suite 200, Malvern, PA 19355-3265 | 2007-05-18 |
| 1629284955 | Kim Einhorn | Obstetrics & Gynecology | 325 Central Ave, Suite 100, Malvern, PA 19355-3265 | 2007-05-15 |
| 1598890667 | Richard F. Koup D.m.d. & Associates LLC | Dentist | 325 Central Ave, Suite 101, Malvern, PA 19355-3219 | 2007-02-22 |
| 1699829515 | Janet T Connell | Psychiatry & Neurology | 325 Central Ave, Suite 102, Malvern, PA 19355-3219 | 2007-01-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588218044 | Novacare Outpatient Rehabilitation East, Inc. | Clinic/Center | 30 Liberty Boulevard, Suite 140, Malvern, PA 19355 | 2019-08-01 |
| 1871011122 | Mary Margaret Bischoff | Psychologist | 922 St. Andrews Dr., Malvern, PA 19355 | 2017-09-07 |
| 1114449527 | Reconstructive Orthopaedic Associates II, P.C. | Prosthetic/Orthotic Supplier | 650 Carnegie Boulevard, 2nd Floor, Malvern, PA 19355 | 2017-07-07 |
| 1285169243 | Smile Exchange of Malvern, LLC | Clinic/Center | 5 S. Morehall Rd, Suite 700b, Malvern, PA 19355 | 2017-04-27 |
| 1669849162 | Sahar Akhtar | Counselor | 288 Lancaster Ave Ste 1, Frazer, PA 19355 | 2015-08-31 |
| 1386020030 | Laura Ann Treston | Physical Therapy Assistant | 60 Malvern Ave., Malvern, PA 19355 | 2015-08-05 |
| 1003217191 | Hillary Schmid | Behavioral Analyst | 28 Clover Lane, Malvern, PA 19355 | 2014-09-09 |
| 1033528799 | James Greco | Pharmacist | 50 Three Tun Rd Ste 2, Malvern, PA 19355 | 2014-08-07 |
| 1952712085 | Rachael Joseph | Community/Behavioral Health | 45 Kelmar Avenue, Malvern, PA 19355 | 2014-05-12 |
| 1487081808 | Ronia Arabatlian | Social Worker | 1 North Bacton Rd, 107, Malvern, PA 19355 | 2013-09-30 |
| Find all providers in zip 19355 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700032828 | Ranjeeb Prasad Shrestha | Psychiatry & Neurology | 655 Sugartown Rd, Malvern, PA 19355-3303 | 2008-08-08 |
| 1508981572 | James Walter Feussner | Psychiatry & Neurology | 655 Sugartown Road, Malvern, PA 19355 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932174 | Northeast Counseling Service | Psychiatry & Neurology | 85 S Old Turnpike Rd, Drums, PA 18222-1731 | 2020-11-06 |
| 1639770647 | Northeast Counseling Service | Psychiatry & Neurology | 275 Mill St, Hazleton, PA 18201-6701 | 2020-11-05 |
| 1225645518 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 723 Coal St, Easton, PA 18042-6556 | 2020-09-30 |
| 1093322380 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 990 Echo Trl, Easton, PA 18040-1014 | 2020-09-30 |
| 1720695141 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 429 Reeder St, Easton, PA 18042-1731 | 2020-09-29 |
| 1710594130 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 1709 Richmond Rd, Easton, PA 18040-8435 | 2020-09-29 |
| 1528675345 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 1315 Echo Trl, Easton, PA 18040-1019 | 2020-09-25 |
| 1164039996 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 1243 Tatamy Rd, Easton, PA 18045-7405 | 2020-09-25 |
| 1578170304 | St. Luke's Physician Group, Inc. | Psychiatry & Neurology | 1221 Northampton St, Easton, PA 18042-4138 | 2020-09-25 |
| 1336754951 | Evergreen Psychiatry LLC | Psychiatry & Neurology | 539 S Bolmar St, West Chester, PA 19382-4934 | 2020-09-10 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. M HOSSEIN ETEZADY.
| 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.