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Individual

KAMBIZ GHALILI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
65 W 55TH ST, EAST 70TH STREET, NEW YORK, NY 10019-4913
(212) 581-5360
Mailing address
65 WEST 55TH STREET, SUIT 305, NEW YORK, NY 10019
(212) 581-5360

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
38060
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
KG1133
DENTISTRY
NY
Enumeration date
02/07/2014
Last updated
02/07/2014
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