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Individual

DR. AYOOB KHODADADI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.,

Contact information

Practice address
2678 GERRITSEN AVE, BROOKLYN, NY 11229-5947
(718) 333-0275
(718) 333-0224
Mailing address
2678 GERRITSEN AVE, BROOKLYN, NY 11229-5947
(718) 333-0275
(718) 333-0224

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
113253-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00717955
NY
Enumeration date
05/11/2006
Last updated
04/16/2008
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