Provider Information for 1952505018
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
SHAWN KHODADADIAN M.D.
Sex: Male
NPI: 1952505018
Last Updated: 2016-11-29
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1952505018 | ||||||||
| Enumeration Date | 2007-06-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 983 PARK AVE NEW YORK, NY 10028-0808 United States Phone: 212-427-8761 | Fax:212-427-8762 | ||||||||
| Primary Practice Address | 983 PARK AVE STE 1D NEW YORK, NY 10028-0808 United States Phone: 212-427-8761 | Fax:212-427-8762 | ||||||||
| Secondary Practice Address(es) | |||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|