Provider Demographics
NPI:1811968613
Name:GHODSI, NEWSHA Z (MD)
Entity type:Individual
Prefix:
First Name:NEWSHA
Middle Name:Z
Last Name:GHODSI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 E 96TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-6217
Mailing Address - Country:US
Mailing Address - Phone:212-426-7300
Mailing Address - Fax:212-426-8385
Practice Address - Street 1:108 E 96TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-6217
Practice Address - Country:US
Practice Address - Phone:212-426-7300
Practice Address - Fax:212-426-8385
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210537207RC0000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02278417Medicaid
NY02278417Medicaid
NG0464Q410Medicare ID - Type Unspecified