Individual
MOHAMMAD ESMAEILZADEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1700 UNION BLVD, BAY SHORE, NY 11706-7955
(631) 665-1600
Mailing address
500 OLD WESTBURY RD, ROSLYN HEIGHTS, NY 11577-2215
(516) 467-6930
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
019622-1
NY
Other
Enumeration date
05/27/2016
Last updated
05/27/2016
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