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General NPI Number Information
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NPI Number | 1821119579
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Entity Type | Organization
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Legal Business Name | BIJAN SETAREH MD
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 2000 N VILLAGE AVE SUITE312
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-1078
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Country | US
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Telephone | 516-678-8777
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Fax | 718-787-1899
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Provider Business Mailing Address
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Address Line | 1550 E 7TH ST
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City | BROOKLYN
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State | NY
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Zip | 11230-6406
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Country | US
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Telephone | 718-787-2215
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Fax | 718-787-1899
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Authorized Official
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Title or Position | PRESIDENT
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Name | BIJAN SETAREH-SHENAS
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Credential | MD
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Telephone | 516-678-8777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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