Basic Information
| Provider Information | |||||||||
| NPI: | 1093989105 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEHKHARGHANI | ||||||||
| FirstName: | SEENA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 660 1ST AVE RM 315 | ||||||||
| Address2: | ATTN: SARAH MCDERMOTT, DEPT. OF RADIOLOGY, NYU | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100163295 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122639531 | ||||||||
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| Practice Location | |||||||||
| Address1: | 660 1ST AVE RM 315 | ||||||||
| Address2: | ATTN: SARAH MCDERMOTT, DEPT. OF RADIOLOGY, NYU | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100163295 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122639531 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2008 | ||||||||
| LastUpdateDate: | 06/29/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 81731 | AZ | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085N0700X | 283312 | NY | Y | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology |
ID Information
| ID | Type | State | Issuer | Description | 81731 | 01 | AZ | TRAINING PERMIT | OTHER |