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General NPI Number Information
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NPI Number | 1568604866
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Entity Type | Organization
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Legal Business Name | SOHAYLA S. ZIVARI
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 09/21/2016
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Provider Practice Location Address
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Address Line | 162 ROUTE 59
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City | AIRMONT
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State | NY
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Zip | 10952-3627
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Country | US
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Telephone | 845-352-9200
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Fax | 845-352-9399
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Provider Business Mailing Address
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Address Line | 162 ROUTE 59
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City | MONSEY
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State | NY
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Zip | 10952
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Country | US
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Telephone | 845-352-9200
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Fax | 845-352-9399
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. BEHROOZ ZIVARI
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Credential |
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Telephone | 845-352-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 052185
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 038351
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License Number State | NY
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