Individual
KIYON NASER-TAVAKOLIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
630 W 168TH ST MC28, NEW YORK, NY 10032
(212) 305-5123
Mailing address
215 E 96TH ST APT 17L, NEW YORK, NY 10128-3947
(415) 717-6649
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
25MA11671900
NJ
2085R0202X
Diagnostic Radiology Physician
316403
NY
2085R0204X
Vascular & Interventional Radiology Physician
25MA11671900
NJ
2085R0204X
Vascular & Interventional Radiology Physician
Primary
316403
NY
Other
Enumeration date
03/27/2017
Last updated
04/08/2024
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