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Organization
KAMYAR DAVID TAVAKOLI PHYSICIAN PLLC
Active
Organization
KAMYAR DAVID TAVAKOLI PHYSICIAN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL TAVAKOLI (BOOKKEEPER)
(718) 217-5200
Entity
Organization
Contact information
Practice address
19115 HILLSIDE AVE, HOLLIS, NY 11423-1941
(718) 217-5200
Mailing address
19115 HILLSIDE AVE, HOLLIS, NY 11423-1941
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
190615
NY
Other
Enumeration date
08/17/2008
Last updated
08/17/2008
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