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General NPI Number Information
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NPI Number | 1275918096
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Entity Type | Organization
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Legal Business Name | DR OMAR BASHAYAN PHYSICIAN PLLC
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Dates
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Enumeration Date | 07/22/2015
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Last Update Date | 07/22/2015
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Provider Practice Location Address
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Address Line | 155 W 68TH ST APT 1102
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City | NEW YORK
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State | NY
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Zip | 10023-5816
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Country | US
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Telephone | 917-374-2944
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Fax | 718-334-3441
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Provider Business Mailing Address
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Address Line | 155 W 68TH ST APT 1102
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City | NEW YORK
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State | NY
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Zip | 10023-5816
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Country | US
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Telephone | 917-374-2944
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Fax | 718-334-3441
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. OMAR BASHAYAN
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Credential |
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Telephone | 917-374-2944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 265495
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License Number State | NY
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