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General NPI Number Information
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NPI Number | 1619206380
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Entity Type | Organization
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Legal Business Name | SHARIYAR HADI DO PC
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Dates
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Enumeration Date | 12/09/2009
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Last Update Date | 12/09/2009
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Provider Practice Location Address
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Address Line | 1893 EASTERN PKWY
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City | BROOKLYN
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State | NY
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Zip | 11233-3440
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Country | US
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Telephone | 718-385-7373
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Fax | 718-385-4759
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Provider Business Mailing Address
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Address Line | 54 FELICIA CT
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City | PLAINVIEW
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State | NY
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Zip | 11803-5731
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Country | US
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Telephone | 516-822-2015
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHARIYAR SHAHANA HADI
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Credential | D.O.
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Telephone | 718-385-7373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 223326-1
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License Number State | NY
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