Provider Demographics
NPI:1427204999
Name:ALIZADEH, MOHSEN GHORBAN (PHARMD)
Entity type:Individual
Prefix:
First Name:MOHSEN
Middle Name:GHORBAN
Last Name:ALIZADEH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:MOHSEN
Other - Middle Name:
Other - Last Name:GHORBANALIZADEH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5075 EDGEMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:19015-0521
Mailing Address - Country:US
Mailing Address - Phone:610-566-2226
Mailing Address - Fax:610-566-0521
Practice Address - Street 1:5075 EDGEMONT AVE
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:PA
Practice Address - Zip Code:19015-0521
Practice Address - Country:US
Practice Address - Phone:610-566-2226
Practice Address - Fax:610-566-0521
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-15
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist