SAMIR DERISAVIFARD

REGO PARK, NY
NPI1477997690
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2088F0040X Urology, Female Pelvic Medicine and Reconstructive Surgery
(Licence: NY  282292-01)
Additional Taxonomies208800000X Urology
(Licence: TX  S5157)
208800000X Urology
(Licence: NY  282292-01)
Enumeration Date2013-04-18
Last Update Date2024-06-12
Business Address
SAMIR DERISAVIFARD MD
9225 QUEENS BLVD FL 2
REGO PARK, NY 11374
Phone number: 817-925-6200
Mailing Address
SAMIR DERISAVIFARD MD
9225 QUEENS BLVD FL 2
REGO PARK, NY 11374
Phone number: