Provider Demographics
NPI:1134394760
Name:DEKALB OB/GYN P.L.L.C.
Entity type:Organization
Organization Name:DEKALB OB/GYN P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ESKANDAR
Authorized Official - Middle Name:J
Authorized Official - Last Name:SIMHAEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-365-6167
Mailing Address - Street 1:PO BOX 234396
Mailing Address - Street 2:OLD VILLAGE STATION
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-4396
Mailing Address - Country:US
Mailing Address - Phone:516-365-6167
Mailing Address - Fax:516-365-6308
Practice Address - Street 1:856 DEKALB AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-1402
Practice Address - Country:US
Practice Address - Phone:718-222-8777
Practice Address - Fax:516-365-6308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY159574207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty