Individual provider · Type 1 NPI

Fred Rezvani

Specialist · Ridgewood, NJ

NPI number 1104887694 Active

Practice location

119 Prospect St, 1st Floor Suite 1
Ridgewood, NJ 07450-4405

Call (201) 444-1600 Map

Fax (201) 444-8774

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X25MA05115800 (NJ)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1104887694

Fred Rezvani's National Provider Identifier is 1104887694, issued on Apr 1, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Ridgewood, NJ. The record was last updated on May 6, 2025.