Provider Demographics
NPI:1073506069
Name:GHESANI, MUNIR V (MD)
Entity Type:Individual
Prefix:DR
First Name:MUNIR
Middle Name:V
Last Name:GHESANI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1780 BROADWAY
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1414
Mailing Address - Country:US
Mailing Address - Phone:212-315-0144
Mailing Address - Fax:212-315-0196
Practice Address - Street 1:425 W 59TH ST
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1104
Practice Address - Country:US
Practice Address - Phone:212-492-5550
Practice Address - Fax:212-492-5555
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-25
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY206076207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01664406Medicaid
NYG29258Medicare UPIN
NY01664406Medicaid