Provider Demographics
NPI:1689813966
Name:ZEHTABCHI, MANIJEH (MD)
Entity Type:Individual
Prefix:
First Name:MANIJEH
Middle Name:
Last Name:ZEHTABCHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:20 YORK ST # T-209
Mailing Address - Street 2:YALE-NEW HAVEN HOSPITAL
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3220
Mailing Address - Country:US
Mailing Address - Phone:203-688-2259
Mailing Address - Fax:203-688-5599
Practice Address - Street 1:20 YORK ST # T-209
Practice Address - Street 2:YALE-NEW HAVEN HOSPITAL
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510
Practice Address - Country:US
Practice Address - Phone:203-688-2259
Practice Address - Fax:203-688-5599
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2018-07-05
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Provider Licenses
StateLicense IDTaxonomies
CT512962085R0202X, 2085N0904X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology