Provider Demographics
NPI:1235012113
Name:RAFIEI, KAVEH (PHARMD)
Entity type:Individual
Prefix:
First Name:KAVEH
Middle Name:
Last Name:RAFIEI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 RAYNHAM DR
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-3909
Mailing Address - Country:US
Mailing Address - Phone:516-653-8244
Mailing Address - Fax:
Practice Address - Street 1:964 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-2119
Practice Address - Country:US
Practice Address - Phone:631-281-2052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist