Fred Rezvani

NPI #1104887694 in Ridgewood, New Jersey

Provider Information

NPI Number: 1104887694
Entity Type: Individual
Name: Fred Rezvani
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: Apr 1, 2006
Last Updated: May 6, 2025

Practice Location

Address: 119 PROSPECT ST
Address 2: 1ST FLOOR SUITE 1
City: Ridgewood
State: New Jersey
ZIP Code: 07450-4405
Phone: (201) 444-1600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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