Provider Demographics
NPI:1104805415
Name:NAINZADEH, NAHID K (MD)
Entity type:Individual
Prefix:
First Name:NAHID
Middle Name:K
Last Name:NAINZADEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 E 102ND ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-5611
Mailing Address - Country:US
Mailing Address - Phone:212-241-5555
Mailing Address - Fax:212-241-5658
Practice Address - Street 1:345 E 102ND ST
Practice Address - Street 2:SUITE 215
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-5611
Practice Address - Country:US
Practice Address - Phone:212-241-5555
Practice Address - Fax:212-241-5658
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127256174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB12439Medicare UPIN
NY294061Medicare ID - Type Unspecified