Most Relevant Information
Provider Data
| NPI Number: | 1003645706 |
| Provider Name: | SEYEDEH PEGAH MIRMALEK |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | 14209 |
Most Important Dates
| Enumeration Date: | 07/31/2024 |
| Last Updated: | 08/09/2024 |
Provider Practice Location
FARMINGTON
FARMINGTON
CT
06030
Practice Location Phone/Fax
| Phone: | 8605036925 |
| Fax: |
Provider Mailing Location
16 RAVENWOOD RD, 06107
WEST HARTFORD
CT
06107
Provider Mailing Phone/Fax
| Phone: | 8605036925 |
| Fax: |