Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 046459 | NY |
NPI | 1033178454 |
---|---|
Provider Name | Dr. Kamran Foroughi |
First Address | New York, NY 10007-3001 |
Second Address | New York, NY 10007-3001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02156090 | (05) | NY |