Provider Demographics
NPI:1841675287
Name:NEZHAT SURGERY FOR GYNECOLOGY/ONCOLOGY, PLLC
Entity type:Organization
Organization Name:NEZHAT SURGERY FOR GYNECOLOGY/ONCOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FARR
Authorized Official - Middle Name:R
Authorized Official - Last Name:NEZHAT, MD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-663-1365
Mailing Address - Street 1:70 E SUNRISE HWY STE 515W
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-1233
Mailing Address - Country:US
Mailing Address - Phone:516-663-1365
Mailing Address - Fax:516-710-7685
Practice Address - Street 1:70 E SUNRISE HWY STE 515W
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-1233
Practice Address - Country:US
Practice Address - Phone:516-663-1365
Practice Address - Fax:516-710-7685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-28
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty