| NPI | 1922396472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN KHODADADIAN Owner 646-351-0911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 244392) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology | |
| 152W00000X Optometrist | |
| 213E00000X Podiatrist | |
| 207N00000X Dermatology | |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2025-10-20 |