Provider Demographics
NPI:1306008727
Name:KIANFAR, HORMOZ (MD)
Entity type:Individual
Prefix:DR
First Name:HORMOZ
Middle Name:
Last Name:KIANFAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 ROUTE 88 W
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-2390
Mailing Address - Country:US
Mailing Address - Phone:732-840-0600
Mailing Address - Fax:732-840-0611
Practice Address - Street 1:1530 ROUTE 88 W
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-2390
Practice Address - Country:US
Practice Address - Phone:949-701-1221
Practice Address - Fax:732-840-0611
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254118207R00000X
NJ25MA09562700207RC0000X, 207RI0011X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease