Active NPI
Seyedeh Pegah Mirmalek
- Student in an Organized Health Care Education/Training Program
- Farmington, CT
National Provider Identifier
1003645706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 14209
- Practice address
- Farmington
Farmington, CT 06030 - Phone
- (860) 503-6925
- NPI assigned
- Jul 31, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 14209 | CT | Primary |
Addresses
Primary practice location
Farmington
Farmington, CT 06030
Mailing address
16 Ravenwood Rd, 06107
West Hartford, CT 06107
Phone (860) 503-6925
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14209 | CT | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723161600000",
"number": "1003645706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 RAVENWOOD RD, 06107",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "06107",
"telephone_number": "860-503-6925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "FARMINGTON",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "06030",
"telephone_number": "860-503-6925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRMALEK",
"first_name": "SEYEDEH PEGAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-31",
"last_updated": "2024-08-09",
"certification_date": "2024-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CT",
"license": "14209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.