Individual
DR. BEHROOZ MANDANIPOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1332 E 36TH ST, BROOKLYN, NY 11234-2704
(718) 926-8855
(646) 308-9202
Mailing address
1332 E 36TH ST, BROOKLYN, NY 11234-2704
(718) 926-8855
(646) 308-9202
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
N005601
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02369946
—
NY
01
—
A300041434
PTAN#
—
Enumeration date
06/03/2006
Last updated
04/02/2012
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