MEDICARE: PEYMAN ZANDIEH, MD PC

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
1	207V00000X	Obstetrics & Gynecology Physician	198779	NY

General Provider Information

NPI Number	:	1437154747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEYMAN ZANDIEH, MD PC

Provider Business Mailing Address
First Line	:	4230 HEMPSTEAD TPKE
Second Line	:	STE 208
City	:	BETHPAGE
State	:	NY
Zip	:	11714-5700
Country	:	US
Telephone Number	:	516-735-7900
Fax Number	:	516-735-8425

Provider Business Practice Location Address
First Line	:	4230 HEMPSTEAD TPKE
Second Line	:	STE 208
City	:	BETHPAGE
State	:	NY
Zip	:	11714-5700
Country	:	US
Telephone Number	:	516-735-7900
Fax Number	:	516-735-8425

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PEYMAN S ZANDIEH
Credential	:
Telephone Number	:	516-735-7900

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	11/02/2007

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