Healthcare Provider Details

I. General information

NPI: 1265499461
Provider Name (Legal Business Name): MAHIN D BEHBEHANIAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3723 ROSEMONT PASS
NEWTOWN SQUARE PA
19073-4106
US

IV. Provider business mailing address

3723 ROSEMONT PASS
NEWTOWN SQUARE PA
19073-4106
US

V. Phone/Fax

Practice location:
  • Phone: 610-745-6701
  • Fax: 610-565-7426
Mailing address:
  • Phone: 610-745-6701
  • Fax: 610-565-7426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD033116L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: