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Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Fred Rezvani

Specialist in Ridgewood, NJ · enumerated 2006.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1104887694

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Registry record

Entity type Individual (Type 1)
Name Fred Rezvani
Sex Male
Practice address 119 Prospect St, 1st Floor Suite 1, Ridgewood, NJ, 07450
Fax (201) 444-8774
Enumeration date Apr 1, 2006
Last updated in NPPES May 6, 2025

Taxonomy & licenses

174400000X Specialist Other Service Providers · License 25MA05115800 (NJ) Primary

Other identifiers

Identifier Type State Issuer
30G161 Other NJ EMPIRE BC/BS OF NY
4226530 Other NJ AETNA PPO #
0K6927 Other NJ HEALTHNET #
BP204 Other NJ OXFORD ID#
0562861001 Other NJ AMERIHEALTH #
0028398 Other NJ AETNA HMO #

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How do I verify Fred Rezvani's NPI record?
Cross-check NPI 1104887694 against the official CMS registry at npiregistry.cms.hhs.gov. This page mirrors the same public NPPES data with a monthly snapshot.
Is NPI 1104887694 active?
Yes, as of the latest NPPES snapshot, NPI 1104887694 is active (record last updated 2025-05-06).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-05-06.