Provider Demographics
NPI:1285391094
Name:NAMAZI-ZADEH, PEGAH (PHARMD)
Entity type:Individual
Prefix:
First Name:PEGAH
Middle Name:
Last Name:NAMAZI-ZADEH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4424 ALPHONSE DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-1203
Mailing Address - Country:US
Mailing Address - Phone:504-717-9113
Mailing Address - Fax:
Practice Address - Street 1:5620 READ BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-3106
Practice Address - Country:US
Practice Address - Phone:504-592-6693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.023649183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist