Organization
KAVEH ALIZADEH MD OF LONG ISLAND, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN R SALAHI (PRACTICE ADMINISTRATOR)
(908) 490-0036
Entity
Organization
Contact information
Practice address
500 N BROADWAY STE 200, JERICHO, NY 11753-2128
(516) 439-5009
Mailing address
45 S PARK PL # 298, MORRISTOWN, NJ 07960-3924
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265868434
PESONAL NPI
—
Enumeration date
09/14/2017
Last updated
09/14/2017
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