Provider Demographics
NPI:1366473589
Name:MOZAFFARIAN, DARIUSH (MD DRPH)
Entity type:Individual
Prefix:DR
First Name:DARIUSH
Middle Name:
Last Name:MOZAFFARIAN
Suffix:
Gender:M
Credentials:MD DRPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 HUNTINGTON AVE BLDG 2-315
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6021
Mailing Address - Country:US
Mailing Address - Phone:617-432-2887
Mailing Address - Fax:617-432-2435
Practice Address - Street 1:665 HUNTINGTON AVE BLDG 2-315
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6021
Practice Address - Country:US
Practice Address - Phone:617-432-2887
Practice Address - Fax:617-432-2435
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218517174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist