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Individual

DR. FOAD GHAVAMI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
501 SEAVIEW AVE, SUITE 100, STATEN ISLAND, NY 10305
(718) 667-0077
(718) 667-4103
Mailing address
501 SEAVIEW AVE, SUITE 100, STATEN ISLAND, NY 10305
(718) 667-0077
(718) 667-4103

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
2161241
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02299892
NY
01
479Q71
MEDICARE ID NUMBER
NY
Enumeration date
12/13/2005
Last updated
06/19/2012
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