| Shahrokh Ganjian | |
|
9737 63rd Rd Ste 1k Rego Park NY 11374-1642 | |
| (718) 897-8900 | |
| (718) 897-6363 |
| Full Name | Shahrokh Ganjian |
|---|---|
| Speciality | Dentist |
| Location | 9737 63rd Rd Ste 1k, Rego Park, New York |
| Authorized Official Name and Position | Shahrokh Ganjian (OWNER) |
| Authorized Official Contact | 7188978900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shahrokh Ganjian 9737 63rd Rd Ste 1k Rego Park NY 11374-1642 Ph: (718) 897-8900 | Shahrokh Ganjian 9737 63rd Rd Ste 1k Rego Park NY 11374-1642 Ph: (718) 897-8900 |
| NPI Number | 1639433667 |
|---|---|
| Provider Enumeration Date | 06/25/2012 |
| Last Update Date | 06/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639433667 | NPI | - | NPPES |
| 01191097 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 041801 (New York) | Primary |
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