Provider Demographics
NPI:1619206380
Name:SHARIYAR HADI DO PC
Entity Type:Organization
Organization Name:SHARIYAR HADI DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARIYAR
Authorized Official - Middle Name:SHAHANA
Authorized Official - Last Name:HADI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-385-7373
Mailing Address - Street 1:54 FELICIA CT
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-5731
Mailing Address - Country:US
Mailing Address - Phone:516-822-2015
Mailing Address - Fax:
Practice Address - Street 1:1893 EASTERN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-3440
Practice Address - Country:US
Practice Address - Phone:718-385-7373
Practice Address - Fax:718-385-4759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223326-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty