Mofazzal Suraiya LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MOFAZZAL SURAIYA LLC

Practice address

3675 Crestwood Pkwy NW Ste 405
Duluth, GA 30096-5129

Phone

(678) 751-1776

NPI assigned

Oct 31, 2025

Organization subpart

No

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

Authorized official

Name

Alija Rivanovic

Title

Owner

Phone

(678) 751-1776

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1761868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761868800000",
    "number": "1497624134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2032 WILDCAT FALLS LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300432985",
            "telephone_number": "678-751-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 CRESTWOOD PKWY NW STE 405",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965129",
            "telephone_number": "678-751-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOFAZZAL SURAIYA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-31",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A",
        "authorized_official_last_name": "RIVANOVIC",
        "authorized_official_first_name": "ALIJA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-751-1776"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.