MEDICARE: MOJGAN NEMAN-KUIGHADUSH M.D.

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	261QM2500X	Medical Specialty Clinic/Center	205047	NY
2	208000000X	Pediatrics Physician	205047	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780769786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOJGAN NEMAN-KUIGHADUSH M.D.

Provider Business Mailing Address
First Line	:	8361 ABINGDON RD
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-1713
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8361 ABINGDON RD
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-1713
Country	:	US
Telephone Number	:	718-441-8666
Fax Number	:	718-441-8667

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	12/23/2024

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