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General NPI Number Information
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NPI Number | 1821097080
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Entity Type | Individual
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Provider Name | DAVID KHODADADIAN MD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | 357A CENTRAL AVE
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City | BROOKLYN
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State | NY
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Zip | 11221-4701
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Country | US
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Telephone | 718-497-1757
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Fax | 718-573-7856
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Provider Business Mailing Address
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Address Line | 357A CENTRAL AVE
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City | BROOKLYN
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State | NY
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Zip | 11221-4701
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Country | US
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Telephone | 917-853-4691
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Fax | 718-573-7856
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 202828
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License Number State | NY
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