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General NPI Number Information
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NPI Number | 1821069048
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Entity Type | Individual
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Provider Name | KAMRAN SADRAZODI M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 10/19/2023
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Provider Practice Location Address
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Address Line | 16303 HORACE HARDING EXPY FL 3
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-1449
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Country | US
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Telephone | 718-445-5100
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Fax | 718-358-1044
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Provider Business Mailing Address
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Address Line | 660 WHITE PLAINS RD STE 400
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City | TARRYTOWN
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State | NY
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Zip | 10591-5107
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Country | US
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Telephone | 914-984-2546
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Fax |
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 235771
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License Number State | NY
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