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General NPI Number Information
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NPI Number | 1083873517
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Entity Type | Individual
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Provider Name | HOOMAN KHORASANI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 135 5TH AVE FL 3
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City | NEW YORK
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State | NY
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Zip | 10010-7158
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Country | US
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Telephone | 212-230-3378
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Fax | 332-777-1113
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Provider Business Mailing Address
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Address Line | 135 5TH AVE FL 3
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City | NEW YORK
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State | NY
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Zip | 10010-7158
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Country | US
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Telephone | 212-230-3378
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A95678485
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 257283
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | 257283
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License Number State | NY
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