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General NPI Number Information
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NPI Number | 1073380853
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Entity Type | Organization
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Legal Business Name | MIDTOWN ENDOSCOPY & SURGICAL CENTER, LLC
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Dates
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Enumeration Date | 12/11/2023
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 147 E 26TH ST
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City | NEW YORK
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State | NY
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Zip | 10010-1868
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Country | US
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Telephone | 646-351-0911
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Fax |
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Provider Business Mailing Address
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Address Line | 121 W 27TH ST
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City | NEW YORK
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State | NY
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Zip | 10001-6207
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Country | US
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Telephone | 646-351-0911
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAWN KHODADADIAN
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Credential | MD
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Telephone | 646-351-0911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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