Provider Demographics
NPI:1982794152
Name:MOTAGHEDI, ROJA (MD)
Entity type:Individual
Prefix:
First Name:ROJA
Middle Name:
Last Name:MOTAGHEDI
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 1:977 48TH ST
Mailing Address - Street 2:DEPARTMENT OF PEDIATRICS
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-2919
Mailing Address - Country:US
Mailing Address - Phone:718-283-8894
Mailing Address - Fax:718-635-7276
Practice Address - Street 1:977 48TH ST
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2919
Practice Address - Country:US
Practice Address - Phone:718-283-8894
Practice Address - Fax:718-635-7276
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY221594208000000X, 2080P0205X, 2080P0205X
WA602181772080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics