Provider Demographics
NPI:1518470004
Name:GHELECHKHANI, MINOU (BS, RVT)
Entity Type:Individual
Prefix:
First Name:MINOU
Middle Name:
Last Name:GHELECHKHANI
Suffix:
Gender:F
Credentials:BS, RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 MORTON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-2140
Mailing Address - Country:US
Mailing Address - Phone:516-603-7377
Mailing Address - Fax:
Practice Address - Street 1:50 MORTON AVE
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-2140
Practice Address - Country:US
Practice Address - Phone:516-603-7377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1657822085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound