Provider Demographics
NPI:1437154747
Name:PEYMAN ZANDIEH, MD PC
Entity Type:Organization
Organization Name:PEYMAN ZANDIEH, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PEYMAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ZANDIEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-735-7900
Mailing Address - Street 1:4230 HEMPSTEAD TPKE
Mailing Address - Street 2:STE 208
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-5700
Mailing Address - Country:US
Mailing Address - Phone:516-735-7900
Mailing Address - Fax:516-735-8425
Practice Address - Street 1:4230 HEMPSTEAD TPKE
Practice Address - Street 2:STE 208
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5700
Practice Address - Country:US
Practice Address - Phone:516-735-7900
Practice Address - Fax:516-735-8425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198779207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY472C31Medicare PIN
NYG48977Medicare UPIN