Individual
SHAYAN KHORSANDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
021715
PR
207V00000X
Obstetrics & Gynecology Physician
25MA10177800
NJ
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
021715
PR
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
021715
PR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/21/2016
Last updated
02/10/2026
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