Provider Demographics
NPI:1205931466
Name:BEHIN, BABAK (MD)
Entity type:Individual
Prefix:DR
First Name:BABAK
Middle Name:
Last Name:BEHIN
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 1:142 PALISADE AVE
Mailing Address - Street 2:SUITE # 207
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-1133
Mailing Address - Country:US
Mailing Address - Phone:201-659-4706
Mailing Address - Fax:201-659-4707
Practice Address - Street 1:142 PALISADE AVE
Practice Address - Street 2:SUITE # 207
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1133
Practice Address - Country:US
Practice Address - Phone:201-659-4706
Practice Address - Fax:201-659-4707
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07314700207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJI24092Medicare UPIN
NJ090834Medicare ID - Type Unspecified