Provider Demographics
NPI:1508136276
Name:BEHESHTIAN, AZADEH (MD)
Entity Type:Individual
Prefix:DR
First Name:AZADEH
Middle Name:
Last Name:BEHESHTIAN
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 1:15 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4348
Mailing Address - Country:US
Mailing Address - Phone:347-558-4094
Mailing Address - Fax:347-558-4094
Practice Address - Street 1:15 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4348
Practice Address - Country:US
Practice Address - Phone:347-558-4094
Practice Address - Fax:833-224-5817
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME133803207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty