Provider Demographics
NPI:1821833732
Name:MAKTABIJAHROMI, NILOUFAR
Entity type:Individual
Prefix:
First Name:NILOUFAR
Middle Name:
Last Name:MAKTABIJAHROMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1454 N ROCHESTER RD APT 100
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1406
Mailing Address - Country:US
Mailing Address - Phone:718-866-6527
Mailing Address - Fax:
Practice Address - Street 1:1135 W UNIVERSITY DR STE 250
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1886
Practice Address - Country:US
Practice Address - Phone:248-601-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program