Provider Demographics
NPI:1396861761
Name:BENHURI, PARVIZ KALIMI (MD)
Entity Type:Individual
Prefix:
First Name:PARVIZ
Middle Name:KALIMI
Last Name:BENHURI
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 1:50 E 72ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4246
Mailing Address - Country:US
Mailing Address - Phone:212-570-1111
Mailing Address - Fax:212-744-4898
Practice Address - Street 1:50 E 72ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4246
Practice Address - Country:US
Practice Address - Phone:212-570-1111
Practice Address - Fax:212-744-4898
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133552207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY133552OtherNY STATE ID
NY00635814Medicaid
CAA34869OtherMEDICAL LICENSE CERT NUMB
NY20A451Medicare ID - Type Unspecified
NY00635814Medicaid