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General NPI Number Information
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NPI Number | 1487201836
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Entity Type | Organization
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Legal Business Name | NABATIAN MEDICAL PRACTICE PLLC
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Dates
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Enumeration Date | 08/21/2019
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Last Update Date | 08/21/2019
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Provider Practice Location Address
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Address Line | 8918 63RD DR
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City | REGO PARK
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State | NY
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Zip | 11374-3858
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Country | US
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Telephone | 718-433-9356
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Fax |
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Provider Business Mailing Address
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Address Line | 4 SPLIT ROCK DR
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City | GREAT NECK
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State | NY
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Zip | 11024-1110
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SEPIDEH NABATIAN
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Credential |
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Telephone | 516-423-6651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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