Provider Demographics
NPI:1447203401
Name:MEHRAN, ROXANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROXANA
Middle Name:
Last Name:MEHRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE GUSTAVE L. LEVY PLACE, INTERVENTIONAL CARDIOLOGY
Mailing Address - Street 2:BOX #1030 MOUNT SINAI SCHOOL OF MEDICINE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-659-9691
Mailing Address - Fax:646-537-8547
Practice Address - Street 1:ONE GUSTAVE L. LEVY PLACE, INTERVENTIONAL CARDIOLOGY
Practice Address - Street 2:#1030 MOUNT SINAI SCHOOL OF MEDICINE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-659-9691
Practice Address - Fax:646-537-8547
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY185790207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE42700Medicare UPIN
NY56B851Medicare ID - Type Unspecified