Most Relevant Information
Provider Data
| NPI Number: | 1003495045 |
| Provider Name: | PEIMAN GHATAN |
| Entity Type: | Individual |
| Taxonomy Code: | 207QA0505X |
| Specialty: | Family Medicine |
| License Number: | 026513 |
Most Important Dates
| Enumeration Date: | 04/06/2021 |
| Last Updated: | 04/06/2021 |
Provider Practice Location
260 MIDDLE NECK RD APT 2M
GREAT NECK
NY
110211160
Practice Location Phone/Fax
| Phone: | 4104586666 |
| Fax: |
Provider Mailing Location
260 MIDDLE NECK RD APT 2M
GREAT NECK
NY
110211160
Provider Mailing Phone/Fax
| Phone: | 4104586666 |
| Fax: |