Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 051768-1 | NY |
Y | 213EG0000X | General Practice | 051768-1 | NY |
NPI | 1003020256 |
---|---|
Provider Name | Dr. Armin Lalehzari |
First Address | New Hyde Park, NY 11040-1228 |
Second Address | Bayside, NY 11361-6546 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 15/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02678893 | (05) | NY |