Individual
FATEMEH DERAKHSHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
622 W 168TH ST PH 15, NEW YORK, NY 10032-3720
(877) 426-5637
Mailing address
475 MAIN ST APT 16A, NEW YORK, NY 10044-0095
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
313804
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/08/2021
Last updated
05/12/2022
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