Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 259578 | NY |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 259578-1 | NY |
N | 208G00000X | Cardiothoracic Vascular Surgeon | LT3350 | NH |
N | 208G00000X | Cardiothoracic Vascular Surgeon | MD475942 | PA |
NPI | 1053676809 |
---|---|
Provider Name | Siyamek Neragi-Miandoab |
First Address | New York, NY 10016-6402 |
Second Address | New York, NY 10016-6402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2012 |
Last Update Date | 09/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1053676809 | (05) | NY |
3094855 | (05) | NH |