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General NPI Number Information
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NPI Number | 1043310253
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Entity Type | Organization
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Legal Business Name | FERAYDOON KOHAN, MD, LLC
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 09/05/2012
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Provider Practice Location Address
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Address Line | 550 NEWARK AVE SUITE 301A
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City | JERSEY CITY
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State | NJ
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Zip | 07306-1326
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Country | US
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Telephone | 201-222-9900
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Fax | 201-222-9929
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Provider Business Mailing Address
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Address Line | PO BOX 220035
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City | GREAT NECK
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State | NY
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Zip | 11022-0035
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Country | US
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Telephone | 201-222-9900
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Fax | 201-222-9929
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Authorized Official
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Title or Position | PRESIDENT
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Name | FERAYDOON KOHAN
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Credential | MD
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Telephone | 201-222-9900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 25MA06900200
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License Number State | NJ
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