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NPI Code Detail

MEDICARE: DR. SORMEH NOURBAKHSH MD

MEDICARE: DR. SORMEH NOURBAKHSH MD
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
12084P0800XPsychiatry Physician337799NY
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1598344731
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SORMEH NOURBAKHSH MD
Provider Business Mailing Address
First Line : 1211 S PRAIRIE AVE APT 4102
Second Line :
City : CHICAGO
State : IL
Zip : 60605-3659
Country : US
Telephone Number : 773-970-8100
Fax Number :
Provider Business Practice Location Address
First Line : 100 WOODS RD
Second Line :
City : VALHALLA
State : NY
Zip : 10595-1530
Country : US
Telephone Number : 914-493-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2021
Last Update Date : 12/18/2025

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