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Individual

MR. KEYVAN JAHANBAKHSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1534 VICTORY BLVD, STATEN ISLAND, NY 10314
(718) 667-3577
(347) 875-1804
Mailing address
1360 HYLAN BLVD, STATEN ISLAND, NY 10305-1922
(718) 667-3577
(347) 875-1797

Taxonomy

Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
25MA11127800
NJ
208VP0000X
Pain Medicine Physician
262483
NY

Other

Enumeration date
05/30/2008
Last updated
12/27/2023
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