=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588112031
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BABAK TOFIGHI, MD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2016
-----------------------------------------------------
Last Update Date | 09/13/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 229 E 28TH ST APT 1B
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-8507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-294-7477
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 229 E 28TH ST APT 1B
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-8507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-294-7477
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. BABAK TOFIGHI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 410-294-7477
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number | 267263
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------