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General NPI Number Information
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NPI Number | 1134394760
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Entity Type | Organization
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Legal Business Name | DEKALB OB/GYN P.L.L.C.
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 04/24/2008
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Provider Practice Location Address
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Address Line | 856 DEKALB AVE
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City | BROOKLYN
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State | NY
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Zip | 11221-1402
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Country | US
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Telephone | 718-222-8777
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Fax | 516-365-6308
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Provider Business Mailing Address
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Address Line | PO BOX 234396 OLD VILLAGE STATION
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City | GREAT NECK
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State | NY
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Zip | 11023-4396
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Country | US
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Telephone | 516-365-6167
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Fax | 516-365-6308
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Authorized Official
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Title or Position | PRESIDENT
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Name | ESKANDAR J. SIMHAEE
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Credential | M.D.
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Telephone | 516-365-6167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 159574
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License Number State | NY
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