Individual
DR. ANOUSHEH GHEZEL-AYAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297
Mailing address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
222991
NY
207RI0200X
Infectious Disease Physician
Primary
222991
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02967164
—
NY
Enumeration date
11/09/2005
Last updated
09/01/2020
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