Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 207067 | NY |
NPI | 1053499392 |
---|---|
Provider Name | Dr. Omid Rahmani |
First Address | New Hyde Park, NY 11042-1011 |
Second Address | New Hyde Park, NY 11042-1011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 01/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02333402 | (05) | NY |
H65642 | (02) | NY |