Healthcare Provider Details

I. General information

NPI: 1093792970
Provider Name (Legal Business Name): NAVID HAKIMIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 10/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 BOSTON RD
BRONX NY
10467-9005
US

IV. Provider business mailing address

2221 BOSTON RD
BRONX NY
10467-9005
US

V. Phone/Fax

Practice location:
  • Phone: 718-519-0600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number189395
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: