Reza Moien MD Internal Medicine LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

039581 Issued in CT

Legal business name

REZA MOIEN MD INTERNAL MEDICINE LLC

Practice address

850 N Main Street Ext
Building#1, Suite D2
Wallingford, CT 06492-2400

Phone

(203) 265-0298

Fax

(203) 265-0361

NPI assigned

Oct 25, 2007

Last updated

Nov 2, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mohammad Reza Moienafshari, M.D.

Title

Owner

Phone

(203) 265-0298

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351814400000",
    "number": "1285813311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 N MAIN STREET EXT",
            "address_2": "BUILDING#1, SUITE D2",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922400",
            "telephone_number": "203-265-0298",
            "fax_number": "203-265-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 N MAIN STREET EXT",
            "address_2": "BUILDING#1, SUITE D2",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922400",
            "telephone_number": "203-265-0298",
            "fax_number": "203-265-0361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REZA MOIEN MD INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-25",
        "last_updated": "2012-11-02",
        "status": "A",
        "authorized_official_last_name": "MOIENAFSHARI",
        "authorized_official_first_name": "MOHAMMAD REZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-265-0298",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "039581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.