Individual
DR. SHAHROKH MOMTAHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
60 EXECUTIVE BLVD, FARMINGDALE, NY 11735-4710
(631) 755-5500
Mailing address
102 GRAYSON ST, STATEN ISLAND, NY 10306-4425
(718) 987-2474
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
231479-1
NY
Other
Enumeration date
03/13/2007
Last updated
03/07/2023
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