Provider Demographics
NPI:1265499461
Name:BEHBEHANIAN, MAHIN D (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHIN
Middle Name:D
Last Name:BEHBEHANIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3723 ROSEMONT PASS
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-4106
Mailing Address - Country:US
Mailing Address - Phone:610-745-6701
Mailing Address - Fax:610-565-7426
Practice Address - Street 1:3723 ROSEMONT PASS
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-4106
Practice Address - Country:US
Practice Address - Phone:610-745-6701
Practice Address - Fax:610-565-7426
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD033116L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001411762Medicaid
B39338Medicare UPIN
142645Medicare ID - Type Unspecified