Provider Demographics
NPI:1619134475
Name:ROHANI, PEJMAN (DO)
Entity type:Individual
Prefix:
First Name:PEJMAN
Middle Name:
Last Name:ROHANI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 E RIDGEVILLE BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-5248
Mailing Address - Country:US
Mailing Address - Phone:240-732-1200
Mailing Address - Fax:877-940-4014
Practice Address - Street 1:106 E RIDGEVILLE BLVD STE 2
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-5248
Practice Address - Country:US
Practice Address - Phone:240-732-1200
Practice Address - Fax:877-940-4014
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB089400002086S0102X, 2086S0129X
NDLT188912086S0129X
UT12841173-12042086S0129X
MDH00974262086S0129X
NY2552112086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0348899OtherGROUP MEDICAID
216927OtherGROUP MEDICARE
216927OtherGROUP MEDICARE
242845YEM4Medicare PIN