Individual provider Active NPI

Marjan Y Tabibzadeh, M.D.

  • Pediatrics Physician
  • Forest Hills, NY
National Provider Identifier
1902901960
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
199640 Issued in NY
Practice address
7238 Yellowstone Blvd
Forest Hills, NY 11375-4134
Phone
(718) 261-9662
Fax
(718) 261-8586
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 199640 NY Primary

Addresses

Primary practice location

7238 Yellowstone Blvd
Forest Hills, NY 11375-4134

Mailing address

7238 Yellowstone Blvd
Forest Hills, NY 11375-4134
Phone (718) 261-9662

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
199640NYMDPediatrics Physician

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902901960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7238 YELLOWSTONE BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754134",
            "telephone_number": "718-261-9662",
            "fax_number": "718-261-8586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7238 YELLOWSTONE BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754134",
            "telephone_number": "718-261-9662",
            "fax_number": "718-261-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABIBZADEH",
        "first_name": "MARJAN",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "199640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.