Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 196191 | NY |
NPI | 1407838766 |
---|---|
Provider Name | Dr. Mehri Songhorian |
First Address | Great Neck, NY 11023-1639 |
Second Address | Elmhurst, NY 11373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2005 |
Last Update Date | 16/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G09462 | (02) | NY |