Healthcare Provider Details

I. General information

NPI: 1932342276
Provider Name (Legal Business Name): MEHRI SONGHORIAN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2009
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2A SHORE PARK RD
GREAT NECK NY
11023-2033
US

IV. Provider business mailing address

2A SHORE PARK RD
GREAT NECK NY
11023-2033
US

V. Phone/Fax

Practice location:
  • Phone: 518-829-1736
  • Fax: 718-592-3844
Mailing address:
  • Phone: 518-829-1736
  • Fax: 718-592-3844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number196191
License Number StateNY

VIII. Authorized Official

Name: DR. MEHRI SONGHORIAN
Title or Position: OWNER
Credential: MD
Phone: 718-760-4221