Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 299603-01 | NY |
N | 207R00000X | Internist | 299603 | NY |
N | 111NI0900X | Internist | 299603 | NY |
N | 207RA0201X | Internist - Allergy & Immunology | 299603 | NY |
NPI | 1518371830 |
---|---|
Provider Name | Sharzad Jasmin Alagheband |
First Address | Glen Cove, NY 11542-2805 |
Second Address | Williston Park, NY 11596-1725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2014 |
Last Update Date | 29/07/2020 |