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DR. M HOSSEIN ETEZADY MD NPI 1548249840


NPI Information

NPI: 1548249840
Provider Name: DR. M HOSSEIN ETEZADY, MD
Classification: Psychiatry & Neurology - 2084P0804X
Entity Type: Individual

Specialization: Child & Adolescent Psychiatry

PECOS Registration: Yes

Address:
325 CENTRAL AVE
SUITE 102
MALVERN, PA
ZIP 19355
Phone: (610) 296-0142
Get Directions

DR. M Hossein Etezady, MD is a child and adolescent psychiatry psychiatry neurology in Malvern, PA. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. DR. M Hossein Etezady, MD NPI is 1548249840. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

325 CENTRAL AVE
SUITE 102
MALVERN, PA
ZIP 19355-219
Phone: (610) 296-0142
Fax: (610) 651-2880

The NPI 1548249840 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/13/2006 and was last updated on 7/9/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084P0804XPsychiatry & NeurologyChild & Adolescent PsychiatryMD031576LPENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1073626P0TMEDICARE ID-TYPE UNSPECIFIEDPENNSYLVANIAGREAT VALLEY HEALTH
20009930090009MEDICAIDPENNSYLVANIA
30009930090008MEDICAIDPENNSYLVANIA
40009930090007MEDICAIDPENNSYLVANIA
5B35002MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.