Healthcare Provider Details

I. General information

NPI: 1285490169
Provider Name (Legal Business Name): KIA GILANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: KIARASH SALEHIGILANI

II. Dates (important events)

Enumeration Date: 02/27/2024
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date: 10/04/2024
Reactivation Date: 10/04/2024

III. Provider practice location address

1468 MADISON AVE
NEW YORK NY
10029
US

IV. Provider business mailing address

PLACE BOX 1137 ONE GUSTAVE L. LEVY
NEW YORK NY
10029
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-6500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number336905
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: