Nyc Internal Medicine Doctor, P.C.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

244392 Issued in NY

Legal business name

NYC INTERNAL MEDICINE DOCTOR, P.C.

Practice address

170 E 78TH St
New York, NY 10075-0408

Phone

(516) 313-8642

NPI assigned

Nov 18, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Shawn Khodadadian, M.D.

Title

Owner

Phone

(516) 313-8642

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416268800000",
    "number": "1265838254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 E 83RD ST",
            "address_2": "APT 2K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100281920",
            "telephone_number": "516-313-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 E 78TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750408",
            "telephone_number": "516-313-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYC INTERNAL MEDICINE DOCTOR, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-18",
        "last_updated": "2014-11-18",
        "status": "A",
        "authorized_official_last_name": "KHODADADIAN",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-313-8642",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "244392",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "244392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in New York, NY
• Providers in New York, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.