Healthcare Provider Details

I. General information

NPI: 1275823460
Provider Name (Legal Business Name): NIMA MAGHAMI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2011
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 E 70TH ST FL 8
NEW YORK NY
10021-9800
US

IV. Provider business mailing address

520 E 70TH ST FL 8
NEW YORK NY
10021-9800
US

V. Phone/Fax

Practice location:
  • Phone: 646-962-8490
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number284450-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: