Healthcare Provider Details

I. General information

NPI: 1356723589
Provider Name (Legal Business Name): NADER DELAVARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2015
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 VAN WYCK EXPY
RICHMOND HILL NY
11418-2832
US

IV. Provider business mailing address

1057 COMMERCE AVE
UNION NJ
07083-5025
US

V. Phone/Fax

Practice location:
  • Phone: 718-206-6000
  • Fax:
Mailing address:
  • Phone: 908-688-8800
  • Fax: 908-688-2377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number311700-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: