Individual
DR. MAHYAR EIDGAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
310 E 14TH ST, NEW YORK, NY 10003-4201
(212) 979-4204
(212) 979-4415
Mailing address
310 E 14TH ST, NEW YORK, NY 10003-4201
(212) 979-4204
(212) 979-4415
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
232944
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02599177
—
NY
Enumeration date
01/29/2007
Last updated
12/20/2007
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