Individual
BAHRAM ELAAHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
STONY BROOK UNIVERSITY HOSPITAL, MEDICAL STAFF OFFICE T14, STONY BROOK, NY 11794-7148
(631) 444-2754
(631) 444-6031
Mailing address
STONY BROOK UNIVERSITY HOSPITAL, MEDICAL STAFF OFFICE T14, STONY BROOK, NY 11794-7148
(631) 444-2754
(631) 444-6031
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
056515
NY
Other
Enumeration date
04/24/2009
Last updated
01/13/2015
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