Individual
MEHDI A MARVASTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
104 UNION AVE, SUITE 1008, SYRACUSE, NY 13203
(315) 422-4442
(315) 448-6126
Mailing address
104 UNION AVE, SUITE 1008, SYRACUSE, NY 13203
(315) 422-4442
(315) 448-6126
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
141551
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00683532
—
NY
Enumeration date
06/08/2005
Last updated
11/05/2012
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