Provider Demographics
NPI:1942340880
Name:VASEGHI, MEHDI (MD)
Entity Type:Individual
Prefix:
First Name:MEHDI
Middle Name:
Last Name:VASEGHI
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 1:2580 LORNA PLACE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11522-1325
Mailing Address - Country:US
Mailing Address - Phone:516-766-2048
Mailing Address - Fax:516-766-2048
Practice Address - Street 1:339 HICKS ST
Practice Address - Street 2:LONG ISLAND COLLEGE HOSPITAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5509
Practice Address - Country:US
Practice Address - Phone:718-780-1682
Practice Address - Fax:718-780-1047
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105654207ZB0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E06937Medicare UPIN