Provider Demographics
NPI:1407830565
Name:SEDIGHI, ABDOLLAH (MD)
Entity type:Individual
Prefix:DR
First Name:ABDOLLAH
Middle Name:
Last Name:SEDIGHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3719 UNION RD STE 218
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-4251
Mailing Address - Country:US
Mailing Address - Phone:716-206-1503
Mailing Address - Fax:716-651-9945
Practice Address - Street 1:310 STERLING DR STE 100
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127
Practice Address - Country:US
Practice Address - Phone:716-677-6800
Practice Address - Fax:716-677-6804
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002130207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02571786Medicaid
NY000541250001OtherBCBS WNY
NY1407830565OtherIHA & NOVA
NYJ400439088OtherMEDICARE PTAN
NY1407830565OtherUNIVERA