Individual
DR. SASSAN MOHTADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
176 N VILLAGE AVE, SUITE 2D, ROCKVILLE CENTRE, NY 11570-3800
(516) 764-2115
Mailing address
16 CLEARMEADOW CT, WOODBURY, NY 11797-1111
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
183543
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454677
—
NY
Enumeration date
12/15/2006
Last updated
04/23/2022
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