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General NPI Number Information
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NPI Number | 1043537756
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Entity Type | Individual
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Provider Name | MICHAEL BASSIRI-TEHRANI
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Gender | Male
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Dates
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Enumeration Date | 04/21/2010
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Last Update Date | 09/15/2016
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Provider Practice Location Address
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Address Line | 61 E 86TH ST STREET ENTRANCE
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City | NEW YORK
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State | NY
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Zip | 10028-1068
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Country | US
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Telephone | 212-339-2001
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Fax | 212-339-2002
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Provider Business Mailing Address
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Address Line | 61 E 86TH ST STREET ENTRANCE (ATTN: KIESERMAN)
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City | NEW YORK
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State | NY
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Zip | 10028-1068
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Country | US
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Telephone | 212-339-2001
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Fax | 212-339-2002
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | A136115
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | 261905
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License Number State | NY
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