Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 195816 | NY |
NPI | 1083672042 |
---|---|
Provider Name | Dr. Javid Nassiri |
First Address | Flushing, NY 11355-5044 |
Second Address | Flushing, NY 11355-5044 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 10/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G75088 | (02) |