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Individual

KOUROSH NOORBAKSH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
227 E 19TH ST, NEW YORK, NY 10003-2602
(212) 995-6160
Mailing address
15 GREENE ST, APT 2, NEW YORK, NY 10013-2500
(212) 925-4991

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
228878
NY
207L00000X
Anesthesiology Physician
Primary
228878
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02583677
NY
Enumeration date
06/15/2005
Last updated
08/04/2023
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