Healthcare Provider Details

I. General information

NPI: 1588659627
Provider Name (Legal Business Name): MELODI BUKET PIRZADA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELODI BUKET KARAKURUM MD

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 03/19/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 MINEOLA BLVD SUITE 210
MINEOLA NY
11501-4073
US

IV. Provider business mailing address

222 STATION PLZ N SUITE 611
MINEOLA NY
11501-3808
US

V. Phone/Fax

Practice location:
  • Phone: 516-663-4600
  • Fax: 516-663-3826
Mailing address:
  • Phone: 516-663-2532
  • Fax: 516-663-2233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number186356
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: