Individual
SEYED ALI MAHDAVIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
374 STOCKHOLM ST, BROOKLYN, NY 11237-4006
(718) 486-4176
(718) 456-0284
Mailing address
166 OLD BROOKFIELD RD UNIT 25-2, DANBURY, CT 06811-4037
(646) 715-3714
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
P04356
NY
208600000X
Surgery Physician
Primary
P04356
NY
Other
Enumeration date
04/29/2019
Last updated
04/29/2019
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