Individual
SASSAN SHAHMANESH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 LINKS CT, PORT WASHINGTON, NY 11050-4709
(516) 767-0069
(516) 767-0069
Mailing address
115 LINKS CT, PORT WASHINGTON, NY 11050-4709
(516) 767-0069
(516) 767-0069
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
090072
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090072
MEDICAL LICENSE
NY
Enumeration date
10/21/2009
Last updated
10/21/2009
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