Provider Demographics
NPI:1194807123
Name:SAFAINILI, FIROUZEH (MD)
Entity type:Individual
Prefix:DR
First Name:FIROUZEH
Middle Name:
Last Name:SAFAINILI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-1621
Mailing Address - Country:US
Mailing Address - Phone:610-642-2604
Mailing Address - Fax:
Practice Address - Street 1:508 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-1621
Practice Address - Country:US
Practice Address - Phone:610-642-2604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-062014L2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1794180Medicaid
PA1794180Medicaid