Organization
COBAM RPA P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAMID BAMSHAD PA (PHYSICIAN ASSISTANT)
(646) 420-4855
Entity
Organization
Contact information
Practice address
6925 170TH ST, FLUSHING, NY 11365-3309
(718) 969-7546
Mailing address
6925 170TH ST, FLUSHING, NY 11365-3309
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
131037-1
NY
363AM0700X
Medical Physician Assistant
Primary
003329-1
NY
Other
Enumeration date
06/04/2013
Last updated
06/04/2013
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