Basic Information
| Provider Information | |||||||||
| NPI: | 1962632364 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PIRESTANI | ||||||||
| FirstName: | ALIREZA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 151 | ||||||||
| Address2: | |||||||||
| City: | NEW CASTLE | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197200151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026522455 | ||||||||
| FaxNumber: | 3023226251 | ||||||||
| Practice Location | |||||||||
| Address1: | 404 FOX HUNT DR | ||||||||
| Address2: | |||||||||
| City: | BEAR | ||||||||
| State: | DE | ||||||||
| PostalCode: | 19701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026522455 | ||||||||
| FaxNumber: | 3023226201 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2009 | ||||||||
| LastUpdateDate: | 12/03/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 125-056572 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | C2-0010489 | DE | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | C2-0010489 | DE | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 125-056572 | IL | N | Allopathic & Osteopathic Physicians | Pediatrics | 207Q00000X | C2-0010489 | DE | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.