Provider Demographics
NPI:1801446596
Name:MICHAEL BASSIRI-TEHRANI MD PLLC
Entity type:Organization
Organization Name:MICHAEL BASSIRI-TEHRANI MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BASSIRI-TEHRANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-476-9556
Mailing Address - Street 1:165 W END AVE APT 8P
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5507
Mailing Address - Country:US
Mailing Address - Phone:516-465-9556
Mailing Address - Fax:
Practice Address - Street 1:61 EAST 86TH ST.
Practice Address - Street 2:PRACTICES AT 86
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028
Practice Address - Country:US
Practice Address - Phone:212-339-2001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty