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Farzad Nourollah-zadeh

NPI Registration Record

Provider / OrganizationNPIDate Certified
FARZAD NOUROLLAH-ZADEH13064516952020-09-13
Entity TypeIndividual
Provider Name Farzad Nourollah-zadeh
Practice Office Address3400 CIVIC CENTER BLVD
PHILADELPHIA, PA US
Practice Office Telephone2673073827
Mailing Address105 S 41ST ST
PHILADELPHIA, PA 191043018 US
Business Telephone2673669949
Contact Endpoints
Direct Messaging Address [][email protected]
HPT Codes
CodeLicense NoState
125Q00000X PRIMARY23-1352685 PA
OPI Codes
45862287 MEDICAID PA
23-1352685 MEDICAID PA

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