Individual
WAHIDULLAH NIAZMAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5645 MAIN ST, FLUSHING, NY 11355-5045
(347) 425-6475
Mailing address
60 BIRCHWOOD DR W, VALLEY STREAM, NY 11580-1940
(347) 425-6475
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
020188-1
NY
Other
Enumeration date
11/21/2016
Last updated
07/07/2023
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