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General NPI Number Information
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NPI Number | 1083233340
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Entity Type | Individual
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Provider Name | SEPIDEH BESHARATI MD
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Gender | Female
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Dates
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Enumeration Date | 04/15/2020
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 622 W 168TH ST VANDERBILT CLINIC BUILDING/14-239
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City | NEW YORK
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State | NY
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Zip | 10032
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Country | US
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Telephone | 301-655-6141
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Fax |
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Provider Business Mailing Address
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Address Line | 1685 BERGEN BLVD APT 703
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City | FORT LEE
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State | NJ
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Zip | 07024-2198
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Country | US
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Telephone | 301-655-6141
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Fax |
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 326207-01
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License Number State | NY
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