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General NPI Number Information
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NPI Number | 1568783181
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Entity Type | Individual
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Provider Name | DANIEL BASSIRI-TEHRANI MD
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Gender | Male
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Dates
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Enumeration Date | 06/17/2010
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Last Update Date | 05/04/2015
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Provider Practice Location Address
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Address Line | 1999 MARCUS AVE SUITE M9
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1033
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Country | US
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Telephone | 516-233-3777
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Fax |
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Provider Business Mailing Address
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Address Line | 280 E MAIN ST
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City | BAY SHORE
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State | NY
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Zip | 11706-8403
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Country | US
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Telephone | 631-647-8984
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Fax | 631-647-8986
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 276629
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License Number State | NY
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