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Individual

DR. SEAN SHAHEEN TEDJARATI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
19 BRADHURST AVE, STE 2575, HAWTHORNE, NY 10532-2140
(914) 493-2181
Mailing address
19 BRADHURST AVE STE 3100N, HAWTHORNE, NY 10532-2140
(914) 493-2181

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
252781
NY
207VX0201X
Gynecologic Oncology Physician
Primary
252781
NY
207VX0201X
Gynecologic Oncology Physician
ME 89380
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03119082
NY
Enumeration date
07/31/2006
Last updated
02/23/2021
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