Provider Demographics
NPI:1588659627
Name:PIRZADA, MELODI BUKET (MD)
Entity Type:Individual
Prefix:
First Name:MELODI
Middle Name:BUKET
Last Name:PIRZADA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELODI
Other - Middle Name:BUKET
Other - Last Name:KARAKURUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:222 STATION PLZ N
Mailing Address - Street 2:SUITE 611
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3808
Mailing Address - Country:US
Mailing Address - Phone:516-663-2532
Mailing Address - Fax:516-663-2233
Practice Address - Street 1:120 MINEOLA BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4073
Practice Address - Country:US
Practice Address - Phone:516-663-4600
Practice Address - Fax:516-663-3826
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1863562080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01551197Medicaid
NY01551197Medicaid