Individual
KOOROSH DAWOODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
21 SOUTH DRIVE, GREAT NECK, NY 11021
(516) 395-2224
(516) 829-1264
Mailing address
21 SOUTH DRIVE, GREAT NECK, NY 11021
(516) 395-2224
(516) 829-1264
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
217724
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02100732
—
NY
01
—
04228
GHI MEICARE
NY
01
—
130022952
RAILROAD MEDICARE
NY
Enumeration date
02/21/2007
Last updated
04/23/2008
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