Provider Demographics
NPI:1215376694
Name:NABEGH, KAMYAR (MD)
Entity Type:Individual
Prefix:
First Name:KAMYAR
Middle Name:
Last Name:NABEGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 BROOK ST APT A
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5441
Mailing Address - Country:US
Mailing Address - Phone:763-443-9555
Mailing Address - Fax:
Practice Address - Street 1:GOHEALTH URGENT CARE
Practice Address - Street 2:77 QUAKER RIDGE ROAD, SUITE #4
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10804
Practice Address - Country:US
Practice Address - Phone:914-266-3104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT54962207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program