Provider Demographics
NPI:1427265438
Name:SAFANI, BAHRAM (MD)
Entity type:Individual
Prefix:DR
First Name:BAHRAM
Middle Name:
Last Name:SAFANI
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 1:2 TIDEWAY
Mailing Address - Street 2:
Mailing Address - City:KINGS POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11024
Mailing Address - Country:US
Mailing Address - Phone:718-788-5050
Mailing Address - Fax:718-768-2770
Practice Address - Street 1:296 7TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3698
Practice Address - Country:US
Practice Address - Phone:718-788-7993
Practice Address - Fax:718-768-2770
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190509207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07351Medicare ID - Type Unspecified
NYF45602Medicare UPIN
NY20L643Medicare ID - Type Unspecified