Provider Demographics
NPI:1396780276
Name:MESBAH, MICHAEL CYRUS (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CYRUS
Last Name:MESBAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:877 STEWART AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4803
Mailing Address - Country:US
Mailing Address - Phone:516-794-1500
Mailing Address - Fax:516-745-1445
Practice Address - Street 1:877 STEWART AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4803
Practice Address - Country:US
Practice Address - Phone:516-794-1500
Practice Address - Fax:516-745-1445
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2022-05-12
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Provider Licenses
StateLicense IDTaxonomies
NY188506207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF82702Medicare UPIN