Individual
DR. SHAHRAM HORMOZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
515 ROUTE 111, 2ND FLOOR, HAUPPAUGE, NY 11788
(631) 224-1819
(631) 224-1812
Mailing address
515 ROUTE 111, SECOND FLOOR, HAUPPAUGE, NY 11788-4339
(631) 224-1819
(631) 224-1812
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
201817
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02192487
—
NY
01
—
163571
VYTRA
NY
01
—
2197789
GHI
NY
01
—
3777960
AETNA/US HEALTHCARE
NY
01
—
58313P
HIP
NY
01
—
608P41
EMPIRE BCBS
NY
01
—
AA71817
MDNY
NY
01
—
P2531781
OXFORD
NY
Enumeration date
01/12/2006
Last updated
01/07/2016
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