Provider Demographics
NPI:1730499898
Name:HAKAMI-KERMANI, ARDESHIR (MD)
Entity Type:Individual
Prefix:DR
First Name:ARDESHIR
Middle Name:
Last Name:HAKAMI-KERMANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 KINGS HIGHWAY, SUITE A7
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234
Mailing Address - Country:US
Mailing Address - Phone:718-677-0109
Mailing Address - Fax:718-677-6693
Practice Address - Street 1:3131 KINGS HIGHWAY, SUITE A7
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234
Practice Address - Country:US
Practice Address - Phone:718-677-0109
Practice Address - Fax:718-677-6693
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY277968208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2103164OtherN/A