Active NPI
Abas Andre Rezvani, MD
- Urology Physician
- Wayne, NJ
National Provider Identifier
1003888934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 29409
- Practice address
- 220 Hamburg Tpke
10
Wayne, NJ 07470-2110 - Phone
- (973) 790-1100
- Fax
- (973) 790-3138
- NPI assigned
- Feb 4, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 29409 | NJ | Primary |
Addresses
Primary practice location
220 Hamburg Tpke
10
Wayne, NJ 07470-2110
Mailing address
220 Hamburg Tpke
Wayne, NJ 07470-2132
Phone (973) 790-1100
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29409 | NJ | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238716800000",
"number": "1003888934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 HAMBURG TPKE",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074702132",
"telephone_number": "973-790-1100",
"fax_number": "973-790-3138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 HAMBURG TPKE",
"address_2": "10",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074702110",
"telephone_number": "973-790-1100",
"fax_number": "973-790-3138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REZVANI",
"first_name": "ABAS",
"middle_name": "ANDRE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-04",
"last_updated": "2009-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NJ",
"license": "29409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.