Individual
DR. PERICLES S HADJIYANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
375 E BAY DR, KOMANOFF CENTER FOR GERIATRIC REHAB, LONG BEACH, NY 11561-2350
(516) 728-1771
Mailing address
PO BOX 7475, WANTAGH, NY 11793-0475
(516) 728-1771
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
198348
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01755215
—
NY
01
—
11051997
MULTIPLAN
NY
01
—
112573413
CNN,HUMN,GAL,HORZ,MAGN
NY
01
—
130021357
RAILROAD MEDICARE
NY
01
—
198348
HIP
NY
01
—
2799832
GHI
NY
01
—
2C8868
HEALTHNET
NY
01
—
6358058002
CIGNA
NY
01
—
67349
VYTRA
NY
01
—
83Y511
BC BS
NY
01
—
970401
HEALTHCARE PARTNERS
NY
01
—
CPMR1298348-5
WC, NO FAULT
NY
01
—
NS0003581
SELECT PRO
NY
01
—
P1537305
OXFORD
NY
Enumeration date
12/14/2005
Last updated
08/07/2013
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