Provider Demographics
NPI:1740305812
Name:NIKKHAH, HAMID NIK (MD)
Entity type:Individual
Prefix:MR
First Name:HAMID
Middle Name:NIK
Last Name:NIKKHAH
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 1:161 E GUNHILL RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467
Mailing Address - Country:US
Mailing Address - Phone:718-547-2011
Mailing Address - Fax:718-547-0341
Practice Address - Street 1:161 E GUNHILL RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-547-2011
Practice Address - Fax:718-547-0341
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY123939207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
29891100Medicare ID - Type Unspecified
C08008Medicare UPIN