| NPI | 1922396472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN KHODADADIAN Owner 516-313-8642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Additional Taxonomies | 152W00000X Optometrist |
| 207N00000X Dermatology | |
| 207R00000X Internal Medicine | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 244392) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology | |
| 213E00000X Podiatrist | |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2021-03-25 |