Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 149314 | NY |
NPI | 1023056512 |
---|---|
Provider Name | Dr. Kambiz Thomas Moazed |
First Address | New York, NY 10041-0004 |
Second Address | New York, NY 10033-2411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 20/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00853269 | (05) | NY |
C05414 | (02) | NY |