Organization
PERICLES HADJIYANE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PERICLES HADJIYANE MD (OWNER)
(516) 596-0500
Entity
Organization
Contact information
Practice address
815 SUNRISE HWY, LYNBROOK, NY 11563-2922
(516) 596-0500
Mailing address
263 RINGWOOD DR, WANTAGH, NY 11793-1902
(516) 596-0500
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A198348
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83Y511
BCBS
NY
Enumeration date
06/13/2014
Last updated
06/13/2014
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