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Individual

MICHAEL KHADAVI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
935 NORTHERN BLVD, STE 104, GREAT NECK, NY 11021
(516) 487-0155
(516) 487-8390
Mailing address
935 NORTHERN BLVD, STE 104, GREAT NECK, NY 11021
(516) 487-0155
(516) 487-8390

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
111343
NY

Other

Enumeration date
08/04/2006
Last updated
07/08/2007
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