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General NPI Number Information
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NPI Number | 1912537564
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Entity Type | Organization
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Legal Business Name | NAIRA AMBARIAN MEDICAL PC
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Dates
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Enumeration Date | 01/23/2020
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Last Update Date | 03/18/2022
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Provider Practice Location Address
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Address Line | 107 NORTHERN BLVD
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City | GREAT NECK
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State | NY
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Zip | 11021-4311
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Country | US
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Telephone | 917-676-3932
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Fax |
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Provider Business Mailing Address
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Address Line | 107 NORTHERN BLVD
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City | GREAT NECK
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State | NY
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Zip | 11021-4311
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Country | US
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Telephone | 929-318-9281
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Fax | 347-556-4558
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | NAIRA AMBARIAN
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Credential | DO
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Telephone | 917-676-3932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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