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NPI Code Detail

MEDICARE: DR. POUNEH FALLAHI M.D.

MEDICARE: DR. POUNEH FALLAHI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician241018NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861581217
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. POUNEH FALLAHI M.D.
Provider Business Mailing Address
First Line : 155 CANAL ST
Second Line :
City : NEW YORK
State : NY
Zip : 10013-4551
Country : US
Telephone Number : 212-431-9010
Fax Number :
Provider Business Practice Location Address
First Line : 155 CANAL ST
Second Line :
City : NEW YORK
State : NY
Zip : 10013-4551
Country : US
Telephone Number : 212-431-9010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 09/12/2013

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