Provider Demographics
NPI:1972636876
Name:TAFRESHI, MEHRAN (DO)
Entity Type:Individual
Prefix:
First Name:MEHRAN
Middle Name:
Last Name:TAFRESHI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270-05 76 AVENUE
Mailing Address - Street 2:LIJMC - DEPT OF MEDICINE
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040
Mailing Address - Country:US
Mailing Address - Phone:516-465-5400
Mailing Address - Fax:
Practice Address - Street 1:270-05 76 AVENUE
Practice Address - Street 2:LIJMC - DEPT OF MEDICINE
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040
Practice Address - Country:US
Practice Address - Phone:516-465-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184087207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease