Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 2018030700 | MO |
Y | 207T00000X | Neurosurgeon | 307619 | NY |
NPI | 1114246543 |
---|---|
Provider Name | Yusef Imani |
First Address | Rockville Centre, NY 11570-4821 |
Second Address | Rockville Centre, NY 11570-4821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2010 |
Last Update Date | 03/09/2021 |