Provider Demographics
NPI:1780073767
Name:MONTAZER RAHMATI, NILOOFAR (OD)
Entity type:Individual
Prefix:DR
First Name:NILOOFAR
Middle Name:
Last Name:MONTAZER RAHMATI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-4304
Mailing Address - Country:US
Mailing Address - Phone:603-898-8560
Mailing Address - Fax:603-870-9271
Practice Address - Street 1:346 S BROADWAY
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-4304
Practice Address - Country:US
Practice Address - Phone:603-898-8560
Practice Address - Fax:603-870-9271
Is Sole Proprietor?:No
Enumeration Date:2015-01-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0899152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist