Fred Rezvani GYN LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

FRED REZVANI GYN LLC

Practice address

119 Prospect St
1St Floor Suite 1
Ridgewood, NJ 07450-4451

Phone

(201) 444-1600

NPI assigned

Feb 7, 2025

Organization subpart

No

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

Authorized official

Name

Fred RezvaniNPI 1104887694

Title

Owner

Phone

(201) 444-1600

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fred Rezvani

  • Specialist
  • Ridgewood, NJ
  • NPI 1104887694
  NPD Authorized official

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

{
    "created_epoch": "1738886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746489600000",
    "number": "1396550463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 PROSPECT ST",
            "address_2": "1ST FLOOR SUITE 1",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504451",
            "telephone_number": "201-444-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 PROSPECT ST",
            "address_2": "1ST FLOOR SUITE 1",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504451",
            "telephone_number": "201-444-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED REZVANI GYN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-07",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A",
        "authorized_official_last_name": "REZVANI",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-444-1600"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Forward ABA Group Inc.
• Fouad Hanna,MD
• Sherlenne Francisco, PSY.D
• Rosemary Frasco, OD
• Margaret Cameron Fraser, MD
• Julia J Freeman, RN, APN,C
• Jessica Lynn Frey, PA-C
• Svetlana Fridlyand, DO
• Carly Samantha Fried, MSN, CPNP-AC
• Jennifer Fritsky, MSW, LCSW

• Obstetrics & Gynecology Physician in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Obstetrics & Gynecology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; 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.