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NPI Code Detail

MEDICARE: RIYAD GIOVANNI BAKSH

MEDICARE: RIYAD GIOVANNI BAKSH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistNY

General Provider Information

NPI Number : 1114876307
Entity Type Code : Individual
Provider Name (Legal Business Name) : RIYAD GIOVANNI BAKSH
Provider Business Mailing Address
First Line : 225 BROADHOLLOW RD STE 402
Second Line :
City : MELVILLE
State : NY
Zip : 11747-4899
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 225 BROADHOLLOW RD STE 402
Second Line :
City : MELVILLE
State : NY
Zip : 11747-4899
Country : US
Telephone Number : 631-385-7780
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2026
Last Update Date : 01/22/2026

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Directions to “ RIYAD GIOVANNI BAKSH ” Practice Location

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