Basic Information
| Provider Information | |||||||||
| NPI: | 1841245149 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARBABZADEH | ||||||||
| FirstName: | MASSOUD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 40 VALLEY STREAM PKWY STE 100 | ||||||||
| Address2: | |||||||||
| City: | MALVERN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193551407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106448900 | ||||||||
| FaxNumber: | 4849240053 | ||||||||
| Practice Location | |||||||||
| Address1: | 1225 MCBRIDE AVE STE 117 | ||||||||
| Address2: | |||||||||
| City: | WOODLAND PARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 074243813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9738371018 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2006 | ||||||||
| LastUpdateDate: | 07/25/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0204X | 255800 | NY | N | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | 2085R0204X | 001841 | NY | N | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | 208D00000X | 62507 | AZ | N | Allopathic & Osteopathic Physicians | General Practice | 2085R0204X | 25MA10476200 | NJ | Y | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology |
ID Information
| ID | Type | State | Issuer | Description | 000527365001 | 01 | BLUE SHIELD OF WESTERN NY | OTHER | 00026468802 | 01 | UNIVERA | OTHER | 1611705 | 01 | INDEPENDANT HEALTH | OTHER | 255800 | 01 | NY LICENSE | OTHER | P00047810 | 01 | RAILROAD MEDICARE | OTHER | 00026468801 | 01 | UNIVERA | OTHER | 02428866 | 05 | NY | MEDICAID |