Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 115279 | NY |
NPI | 1114132479 |
---|---|
Provider Name | Ali Seid Mirhosseini |
First Address | Ossining, NY 10562-3300 |
Second Address | Jamaica, NY 11432-3730 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00947044 | (05) | NY |