Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD435632 | PA |
Y | 208600000X | Surgeon | MD435632 | PA |
N | 2086S0105X | Surgery of the Hand | 25MA07782200 | NJ |
N | 2086S0105X | Surgery of the Hand | MD435632 | PA |
N | 2086S0122X | Plastic and Reconstructive Surgery | 25MA07782200 | NJ |
N | 2086S0122X | Plastic and Reconstructive Surgery | MD435632 | PA |
NPI | 1447215678 |
---|---|
Provider Name | Amir Babak Behnam |
First Address | Reading, PA 19612-3579 |
Second Address | Wyomissing, PA 19610-3333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 26/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102209241 | (05) | PA |
I47468 | (02) |