Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 228099 | NY |
N | 111NI0900X | Internist | 228099 | NY |
Y | 207RA0401X | Internist - Addiction Medicine | 228099 | NY |
NPI | 1821114380 |
---|---|
Provider Name | Shadi Nahvi |
First Address | Bronx, NY 10461-2700 |
Second Address | Bronx, NY 10451-3512 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 22/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00245643 | (05) | NY |