Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 261905 | NY |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A136115 | CA |
NPI | 1043537756 |
---|---|
Provider Name | Michael Bassiri-Tehrani |
First Address | New York, NY 10028-1068 |
Second Address | New York, NY 10028-1068 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2010 |
Last Update Date | 15/09/2016 |