Provider Demographics
NPI:1427105253
Name:BEHZADI, HAMID (MD, FCCP, FCCM)
Entity type:Individual
Prefix:
First Name:HAMID
Middle Name:
Last Name:BEHZADI
Suffix:
Gender:M
Credentials:MD, FCCP, FCCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CUTLER CT
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-2701
Mailing Address - Country:US
Mailing Address - Phone:914-426-1748
Mailing Address - Fax:
Practice Address - Street 1:122 W 70TH ST
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4401
Practice Address - Country:US
Practice Address - Phone:212-581-5225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198276207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01632397Medicaid
NYG27240Medicare UPIN
NY761541Medicare ID - Type Unspecified