Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 187048 | NY |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD419613 | PA |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | ME132022 | FL |
NPI | 1083689921 |
---|---|
Provider Name | Fereshteh Boozarjomehri |
First Address | Danville, PA 17822-4903 |
Second Address | Kingston, PA 18704-4968 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 11/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F19916 | (02) |