Individual
DR. JERALD DARVISHZADEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
900 FRANKLIN AVE, ANESTHESIA DEPARTMENT, VALLEY STREAM, NY 11580-2145
(516) 256-6134
Mailing address
66 POWERHOUSE RD, 3RD FLOOR, ROSLYN HEIGHTS, NY 11577-1324
(516) 626-6366
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
229816
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02579679
—
NY
Enumeration date
06/15/2005
Last updated
07/08/2007
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