Organization
NYC INTERNAL MEDICINE DOCTOR, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAWN KHODADADIAN M.D. (OWNER)
(516) 313-8642
Entity
Organization
Contact information
Practice address
170 E 78TH ST, NEW YORK, NY 10075-0408
(516) 313-8642
Mailing address
170 E 83RD ST, APT 2K, NEW YORK, NY 10028-1920
(516) 313-8642
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
244392
NY
207RG0100X
Gastroenterology Physician
Primary
244392
NY
Other
Enumeration date
11/18/2014
Last updated
11/18/2014
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