Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 194807 | NY |
N | 111NI0900X | Internist | 194807 | NY |
Y | 207RG0100X | Gastroenterologist | 194807 | NY |
NPI | 1003839374 |
---|---|
Provider Name | Dr. Babak Mohajer |
First Address | New York, NY 10010-6802 |
Second Address | New York, NY 10010-6802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 16/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H19554 | (02) |