Individual
AMIR ANSARI-EZABADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MMG - GRAND CONCOURSE, 2532 GRAND CONCOURSE, BRONX, NY 10458
(718) 960-1500
Mailing address
2532 GRAND CONCOURSE, MMG-GRAND CONCOURSE, BRONX, NY 10458-3612
(718) 960-1500
(718) 960-2178
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
207213
NY
Other
Enumeration date
10/02/2006
Last updated
09/18/2009
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