Individual
ELHAM KHAZAEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
355 BARD AVE, STATEN ISLAND, NY 10310-1664
(718) 818-1234
Mailing address
355 BARD AVE, STATEN ISLAND, NY 10310-1664
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
R10755
NY
Other
Enumeration date
07/14/2018
Last updated
01/04/2023
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